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Over the past year, Medicare Advantage Private Fee-for-Service plans have seen immense growth, doubling the amount of enrollees nationwide. This growth provided access to care for countless members, especially in rural areas- but the record increase has been marred by countless reports of miscommunication between sales agents and beneficiaries regarding the services provided in PFFS plans. In addition, providers are becoming increasingly frustrated over delayed claims responses and falling payment rates, and as a result are no longer participating in PFFS plans. In an effort to reduce compliance concerns and expedite reviews, CMS is increasing its oversight of PFFS and suggests that the focus for health plans in 2009 should be on taking proactive measures to address challenges through increased self-monitoring. ExL Health is proud to present a conference providing PFFS plans with insight and strategies into overcoming compliance and operational challenges. Presentations will analyze the current and future status of PFFS plans while offering tactics for improving provider relations, developing beneficiary relationships and remaining compliant within sales and marketing guidelines.
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