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Changes to claims payment for Medicare Advantage inpatient stays

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Changes to claims payment for Medicare Advantage inpatient stays

12/31/2019

Starting Jan. 1, 2020, ConnectiCare will only process the inlier payment of an in-patient stay for our Medicare Advantage claims. The outlier portion of the claim will be denied until we receive an itemized bill from the provider. Payment for the applicable outlier amount will be released after ConnectiCare reviews the itemized bill. This process will only apply to claims that meet the applicable dollar threshold that triggers the review.

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Any information provided on this Website is for informational purposes only. It is not medical advice and should not be substituted for regular consultation with your health care provider. If you have any concerns about your health, please contact your health care provider's office.

Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan. Please refer to your Membership Agreement, Certificate of Coverage, Benefit Summary, or other plan documents for specific information about your benefits coverage.