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Medicare Advantage Provider Administrative Policy (MA PAP)

 

MA200 - MA299       Provider Information

MA200 Participation Requirements 
MA201 Credentialing / Recredentialing Standards for Practitioners 
MA202 Availability
MA203 Access to Care Guidelines 
MA204 Compensation
MA205 Changes in Practice 
MA206 Primary Care Physicians (PCPs) 
MA207 Responsibilities of Contracted Specialist and Healthcare Professionals 
MA208 Emergency and Urgent Services
MA209 Medical Records Standards
MA210 Confidentiality of Member Records
MA211 Primary Care Physician (PCP) Changes for True Blue
MA212 Changes in Member Status
MA213 Claims Submission / Payment
MA214 Electronic Billing of Medicare Advantage Claims
MA215 Claims Status and Corrected Claims
MA216 Claims Encounter Data Language
MA218 Chiropractic Services
MA219 New Providers Joining Contracting Groups
MA220 Crediting Remittance Advices on Previously Processed Claims
MA221 Hospital Outpatient Observation
MA222 Direct Correspondence with a Medicare Advantage Member
MA223 Request for Member Education
MA224 Credentialing Appeal Rights 
MA225 Vision Hardware Billing
MA226 Data Accuracy
MA227 Allowances
MA228 Place of Service
MA229 Inquiry and Appeals Process
MA230 Use of Modifiers
MA232 On-Line Formulary Authorization Forms
MA233 Medicare Advantage Payment Dispute Resolution Process
MA234 Notice of Medicare Non-coverage (NOMNC) Reporting
MA235 Maximum Daily Frequency Edits
MA236 Outpatient Code Edits and Remittance Advice Codes
MA237 Claim Changes from Inpatient to Outpatient Observation
MA238 Online Remittance Advice
MA239 Incomplete Contracts
MA240 Credentialing/Recredentialing Standards for Facilities
MA241 Billing Guidelines for Intensity Modulated Radiation Therapy
MA242 Renal Dialysis Services Billing
MA243 DME Capped Rental
MA244 Bilateral Billing for Ambulatory Surgery Centers
MA245 Follow-up After Hospitalization for Mental Illness Incentive