How does USA Senior Care Network work?

AWARENESS:

Knowledge of the program is generated through mailings and information on the carrier website. The USA SCN logo and customer care phone number are prominently located on the policyholder’s Medicare ID card.

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, 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 Claims and Premium Reduction (MediGap CPR®) Program:

Awareness: Knowledge of the program is generated through mailings and information on the carrier website. The USA SCN logo and customer care phone number are prominently located on the policyholder’s Medicare ID card.
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, 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.