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Regarding the clinical access piece:
MSA plans are truly non-network and work like as Original Medicare in that any provider that accepts Medicare and is accepting new patients must accept MSA plan members.
We did confirm with CMS this clinical access piece. It's different than PFFS, HMO-POS nor OON PPO with regard to access rules.
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I have been selling MSA's for the last 3 years .. we have two MSA's in our state ..while a good option you need to educate your clients if they do have expenses the paperwork is tricky... confusing to many seniors . I have had to move some to MAPD's or MedSupp
Does this also mean that the provider is free of insurance carrier control and reporting requirements that they have to meet when accepting other Medicare Advantage plans?
You really do need some new material.Everybody cares about you, your questions and your concerns. You belong here.
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Since we're non-network, we don't have a contract with the provider to enforce any control or reporting requirements. We simply piggy back off of the provider's contract with Original Medicare as a basis to pay them.Does this also mean that the provider is free of insurance carrier control and reporting requirements that they have to meet when accepting other Medicare Advantage plans?