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lake 7377942 1920
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12.1.2024 Comprehensive for Website UHMAP
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Provider Appeals
Payment Appeal – A challenge or an ‘appeal’ related to benefit/payment denials by the Medicare health plan that results in zero payment being made to the non-contracted Medicare health plan provider. Examples include: Benefit Determinations Medical necessity issues Coverage issues related to nation and/or local coverage determination policies Claims Payment Dispute – Any decision…
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learn
Are you ready to learn more about Medicare? PrimeTime Health Plan offers Medicare Education webinars you can attend from the comfort of your home! Live Webinars: Select a date and time from the list below to attend a live webinar from your home. Once registered, you will receive an email with detailed information…
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10.1.2024 ST Criteria for Website PTHP
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Interoperability
Currently available to PrimeTime Health Plan Medicare Advantage Members and AultCare Marketplace Members. You may find a mobile app or computer program that requests access to your health information to help you monitor your personal health goals. As your health plan, we need to provide a way for you to…
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12.1.2024 ST Criteria for Website PTHP
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National Resources
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H3664 M3P ParticipationRequest C
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2024 Formularies
PrimeTime Health Plan formulary covers both brand name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as…
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