An Aetna Medicare Advantage (MA) patient is coming for outpatient therapy services. You want to provide a service that the MA plan does not cover. You inform the patient of their financial responsibility. The patient agrees to pay you this fee for the noncovered service(s). You think you have done this process correctly. But wait, maybe you have not done it correctly. Contracted providers can’t bill Aetna MA patients for a service not covered under their planunless the provider or the patient obtain

Aetna Medicare Advantage plans may not cover all the outpatient therapy services your patient requires. For the services that they do not cover, does this mean you can charge the patient cash? In this article, I will provide you answers to the following questions:

UnitedHealthcare has announced they will be adding the GA modifier requirement. In this article, I will answer the following questions: