Medicare Advantage Plans/MCO

[Missouri Public Health Association]

Is anyone contracted with any of the Medicare Advantage/MCO Plans?

[Missouri Public Health Association]

Yes. United Healthcare, Anthem are our two most common.

[Missouri Public Health Association]

Yes. Aetna, UHC and Humana are the main ones we get.

[Missouri Public Health Association]

Do either of you have a Compliance Program set up for your LPHA? I am trying to get educated on how to go about this since Aetna Medicare informed me it is a requirement of being contracted. Any information would be so appreciated. Aetna Medicare has sent me two guides to reference- The FDR Medicare Compliance Guide and DSNP Model of Care. When reviewing these they seem so intense and not really geared towards small Health Departments.

If you have any guidance on setting up a compliance program or where I can find more resources for this please email me. holli.johnson@lchdmo.org

Thank you- Holli Johnson- Lincoln County Health Department

[Missouri Public Health Association]

We bill all the Medicare Advantage plans. BCBS, United, Humana and Aetna.

[Missouri Public Health Association]

Holli, don’t sweat this. I’ll send you something this week.

[Missouri Public Health Association]

Cheryl- I really appreciate that.

[Missouri Public Health Association]

Cheryl, I am working on getting some contracting as well. If you are able to forward information to me as well, I would appreciate it. sschmerold@sccmo.org (St. Charles County).

[Author]

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