First Tier, Downstream and Related Entities (FDR) Guide Aetna’s in-depth guide to the FDR Medicare Compliance Program is an excellent resource for new employees and for seasoned employees who must deal with an unusual or new situation with one of your Medicare patients. It addresses the attestation requirements for the program in detail and explains…
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First Tier, Downstream, or Related Entity FDR is a Centers for Medicare and Medicaid Services (CMS) acronym for First tier, Downstream, or Related entity. A First Tier Entity is any party that enters into a written arrangement (acceptable to CMS) with a Medicare Advantage (MA) organization to provide administrative or health care services to a…
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Medicare Advantage Plans FAQs Q: What is a Medicare Advantage Plan? A: According to www.Medicare.gov, a Medicare Advantage Plan (like an HMO or PPO) is a Medicare health plan that qualified beneficiaries may choose as part of their Medicare packages. These plans are very similar to traditional Health Management Organizations (HMOs), Preferred Provider Organizations (PPOs)…
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Important Facts about MA Plans Although a Medicare Advantage (MA) plan is technically a form of Medicare coverage, it is best to view these plans similarly to your contracted commercial payers. Advantage Plans often follow the same billing rules as regular commercial carriers. If you are a contracted provider for the plan the patient belongs…
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Original Medicare vs. Medicare Advantage To expand on your knowledge of Medicare Part C (Advantage) plans, also known as replacement plans, this resource calls out various facts to be aware of as you develop your Medicare education. Remember, these plans replace Part B Medicare, and depending on the type of plan, the provider may need…
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Medicare Advantage Plan Coverage According to www.Medicare.gov, a Medicare Advantage (MA) Plan (like an HMO or PPO) is a Medicare health plan that qualified beneficiaries may choose as part of their Medicare package. These plans are very similar to traditional Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs) and Private Fee for Service (PFFS) plans….
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