With the increase in the popularity of Medicare Advantage Plans among retirees, the opportunity for this additional revenue source has become more essential to the survival of homecare providers. A multitude of managed care contracting opportunities present a provider with increased revenue when contracted on a fee-for-service basis.

While there are some Medicare Advantage Plans that will offer a percentage of the Traditional Medicare PDGM for reimbursement (which requires waiting for the Final RAP payment), there are many more that pay based a straight forward Fee For Service (FFS) schedule. The FFS schedule allows the provider to bill as soon as services are rendered (once all required orders and care plans are in place). In theory, that could result in payment within 20-30 days post service, depending on the health plan and how the claim was submitted (i.e. electronic filing).

Managed Care contracting will additional revenue streams outside of Traditional Medicare, including:

  • Medicare Advantage plans
  • Commercial health plans
    • Employers
    • Health Insurance Exchange
    • Insurance brokers
  • Liability-based coverage
    • Worker’s compensation
    • Automobile policies
    • General liability policies
  • Medicaid Managed Care programs

Please contact us to see how we can best assist your Agency with your managed care needs.