The purpose of this article is to address frequently asked questions (FAQs) from our {PPrX EHR} providers about seeing clients covered by Medicare Advantage and Managed Medicaid plans.
Medicare beneficiaries primarily consist of people over the age of 65 (but also include some people who are under 65 with certain conditions or disabilities).
Medicaid beneficiaries primarily consist of low-income individuals.
These patients can encounter a limited pool of providers, as not all providers are eligible to treat these beneficiaries or bill for services.
Expanding our services to this patient population is a continuation of The Perfect Prescription’s mission to make mental healthcare work for everyone. Thank you for working with us to provide critical care to these patients!
The Perfect Prescription is always striving to expand coverage for our patients. Please reach out to your Provider Success Associate at [email protected] if you have any questions about our in-network status with a specific plan you want to check.
Compensation will be the same when treating Medicare Advantage and Medicaid clients as it is for commercial clients. If you have additional payment questions, please reach out to the Accounts Payable team at [email protected] .
There is no payment for missed or canceled appointments. If a client cancels or does not show up for their appointment, you will not receive compensation for that time. However, you are still required to document the missed appointment in the EHR by completing the missed appointment note as usual.
As The Perfect Prescription navigates this new patient population, it will not be charging no-show fees for patients at this time. Our priority is to ensure that these patients get access to timely care, so some parts of their experience here may still include this messaging. Rest assured, they will not be charged and can ignore that messaging.
In most cases, how you conduct your day-to-day tasks will be the same for Medicare Advantage and most Managed Medicaid patients. Please reach out to us if you have specific questions about your workflows!
At the moment, our platform lets you set limits on your overall patient and caseload, which would apply across all patients (commercial, Medicare, and Medicaid). Regardless of coverage type, your patients will still be able to find & match with you based on your key areas of expertise and other profile details.
We are committed to making this process as seamless and non-confusing as possible.
For instructions on how to see Medicare Advantage clients, please see this article
For instructions on seeing Managed Medicaid clients for states that The Perfect Prescription is currently live in, please reach out to your Provider Success Associate.
Don’t hesitate to reach out to us at [email protected] if you have any questions or need support as you get started.
No, you can take these steps at any point during your time at The Perfect Prescription. If you do not want to complete these at onboarding, can you always come back and complete them later.
If you would no longer like to see Medicare or Medicaid clients through The Perfect Prescription, please reach out to [email protected], and let us know, and we will mark it in our internal systems. You can change your decision to see these patient populations at any point in your {PPrX EHR} journey.
Yes. Your benefits can be reassigned to more than one employer/group. You will receive a different PTAN for each case, and you will be able to see all the groups that you are linked to via your PECOS portal.
Click here to review the terms for Medicare Advantage at The Perfect Prescription.
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