How does USA Senior Care Network work?

AWARENESS:

Knowledge of the program is generated through mailings and information on the carrier website. Network recognition is identified with the USA SCN name/logo and customer care phone number on the policyholder’s Medicare Supplement ID card and/or with USA SCN name on EOB/ERA.

PHYSICIAN OUTREACH:

We contact physicians with privileges at contracted hospitals, confirm they participate in Medicare and take new patients, and add them to our Physician Database.

CUSTOMER CARE:

Our staff helps policyholders locate the closest network hospital. Should the policyholder need a physician, our staff can provide the names of physicians who admit at the network facility.

IN-PATIENT UTILIZATION:

When policyholders need an in-patient procedure, there is no need for pre-approvals or prior authorizations beyond the typical Medicare requirements, greatly simplifying the admission process.

POLICYHOLDER CLAIMS:

Filing claims follows the same straightforward process used for basic Medicare policyholders. There is no special workflow.

CLAIMS PAYMENT:

Hospitals are reimbursed at full Medicare rates. The Explanation of Benefits includes the code for the USA Senior Care contractual agreement.

OUT-PATIENT UTILIZATION:

There is no Part B waiver or discounts with the program. Providers are reimbursed at the full Medicare rates.

MediGap CPR® Program:

Awareness: Knowledge of the program is generated through mailings and information on the carrier website. Network recognition is identified with the USA SCN name/logo and customer care phone number on the policyholder’s Medicare Supplement ID card and/or with USA SCN name on EOB/ERA.
Physician Outreach: We contact physicians with privileges at contracted hospitals, confirm they participate in Medicare and take new patients, and add them to our Physician Database.
Customer Care: Our staff helps policyholders locate the closest network hospital. Should the policyholder need a physician, our staff can provide the names of physicians who admit at the network facility.
In-Patient Utilization: When policyholders need an in-patient procedure, there is no need for pre-approvals or prior authorizations beyond the typical Medicare requirements, greatly simplifying the admission process.
Policyholder Claims: Filing claims follows the same straightforward process used for basic Medicare policyholders. There is no special workflow.
Claims Payment: Hospitals are reimbursed at full Medicare rates. The Explanation of Benefits includes the code for the USA Senior Care contractual agreement.
Out-Patient Utilization: There is no Part B waiver or discounts with the program. Providers are reimbursed at the full Medicare rates.