Dual Eligible Special Needs Plans - provider training required

In 2019, Empire is offering Dual Eligible Special Needs Plans (D-SNPs) to people who are eligible for both Medicare and Medicaid benefits or who are qualified Medicare beneficiaries (QMBs).  D-SNPs provide enhanced benefits to people eligible for both Medicare and Medicaid. These plans are $0 premium plans.  Some include a combination of supplemental benefits such as hearing, dental, vision as well as transportation to doctors’ appointments.  Some D-SNP plans may also include a card or catalog for purchasing over-the-counter items.  

 

Providers who are contracted for D-SNP plans are required to complete annual training to keep up-to-date on plan benefits and requirements, including coordination of care and Model of Care elements. Providers contracted for our D-SNP plans will receive notices in Q1 2019 that contain information for online training through self-paced training through our training site, hosted by SkillSoft. Every provider contracted for our D-SNP plans is required to complete this annual training and click the attestation within the training site stating that they have completed the training. These attestations can be completed by individual providers or at the group level with one signature.

 

Centers for Medicare & Medicaid Services regulations protect D-SNP members from balance billing.

 

For any questions regarding how claims are paid, please contact Provider Services by calling the number on the back of the member’s ID card.

 

75743MUPENMUB 01/24/2019