How does USA Senior Care Network work?
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.
We contact physicians with privileges at contracted hospitals, confirm they participate in Medicare and take new patients, and add them to our Physician Database.
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.
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.
Filing claims follows the same straightforward process used for basic Medicare policyholders. There is no special workflow.
Hospitals are reimbursed at full Medicare rates. The Explanation of Benefits includes the code for the USA Senior Care contractual agreement.
There is no Part B waiver or discounts with the program. Providers are reimbursed at the full Medicare rates.