Plan Library - Medicare
Medicare Advantage Expedited Determination Notices
Learn about Medicare Advantage expedited determination notices, including NOMNC and DENC forms, requirements for service termination, and appeal processes for HMSA members.
Medicare Advantage Hospice VBID
Learn about Medicare Advantage hospice VBID TCC, including coverage coordination, benefits, and guidelines for comprehensive end-of-life care.
Medicare Advantage Provider Appeals
Guidelines for Medicare Advantage provider appeals, including claim review options, submission requirements, timelines, and processes for resolving payment disputes.
Medicare Coverage for Colonoscopy Screenings
Learn about Medicare coverage for colonoscopy screenings, including eligibility, preventive benefits, frequency guidelines, and billing requirements.
Medicare Diabetes Prevention Program
Guidelines for the Medicare Diabetes Prevention Program, including eligibility criteria, program benefits, and provider participation requirements.
Medicare Library
Access the Medicare library, including policies, guidelines, and resources to support coverage decisions, billing, and compliance.
Medicare Members
Guidelines for Medicare members’ rights notices, including CMS requirements for providing and displaying coverage determination and exception information.
Medicare Part D Report to Member (RTM)
Learn about Medicare Part D Report to Member (RTM), including reporting requirements, member notifications, and compliance guidelines for prescription benefits.
Medicare Provider Wait Time Standards
Learn about Medicare provider wait time standards, including appointment access requirements, scheduling benchmarks, and guidelines for timely patient care.
Medicare Star Ratings
Overview of Medicare Star Ratings, including CMS quality measures, provider performance evaluation, and supporting resources for improving care outcomes.