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I have just discovered something, might be late to the game but I have great concern with this. I am wondering how others are handling Medicare electronic eligibility. Medicare will verify as active even if they have a replacement/advantage plan. we had a patient present with his medicare card but actually has Coventry Advantra- We checked eligibility through GE and it shows active- technically it is active, then if I look through all the data returned it does say evidence of Medicare Advantage plan. Fortunately it was one of the replacement plans we participate with.
so my question... do you open every medicare eligibility and make sure it doesn't say anything about an advantage plan? way labor intensive, or pray you never get a patient with an advantage plan you don't participate with? Neither are good options to me.
Hilary
Posted : July 17, 2015 9:24 am
Topic starter
Good news! GE has the ability to flag these accounts. I had them set patient to inactive if it shows the replacement plan, then move the replacement plan data to the top. Works like a charm!
Posted : July 22, 2015 8:49 am
