How do I contact Viva Health Medicare MTM program?
For more information on Viva Health Medicare MTM Program, please contact our member services department at 1-800-633-1542 or 205-918-2067, TTY users call 711. The hours are Monday-Friday, 8 am - 8 pm. From October 1st through March 31st, seven days a week, 8 am - 8 pm.
What are the requirements for an MRI for Medicare?
These requirements include the following criteria: The MRI must be prescribed by your doctor or health care provider as part of the treatment for a medical issue. All parties involved in the procedure, (i.e. the doctor who prescribes the. MRI and the provider administering the MRI) must accept Medicare assignment.
Why choose Viva Medicare?
Our Viva Medicare agents are all a part of your community. They can help you over the phone or meet you in person in a setting where you feel most comfortable – whether it’s at your home or at a local restaurant.
What is the star rating for Viva Medicare in Alabama?
5 out of 5 Stars! Highest Star Rating for a plan in Alabama 1 Enjoy the Benefits! A Four Star rating or higher allows us to offer better benefits and keep our copays low. Learn how you can help! Our Viva Health / Viva Medicare mobile app can make your life easier. Download it for FREE today!
Does Viva Medicare require a referral?
No referrals needed. VIVA MEDICARE: VIVA MEDICARE is only available in participating counties and the member must choose a PCP. No PCP referral is required for members to see a participating specialist within the chosen provider system.
Who qualifies for VIVA Medicare?
If you turned 65 in the past three months or are turning 65 in the next three months, you are likely eligible to enroll in a Viva Medicare plan if you live in our service area. More importantly, we can help you enroll in the right plan for you.
What is VIVA Medicare extra value?
VIVA MEDICARE Extra Value also covers up to $2,250 for preventive, diagnostic, and comprehensive dental benefits every year. You pay anything over $2,250. No copay for Medicare-covered preventive screenings and Medicare-covered eye exams.
When a provider is non participating they will expect?
When a provider is non-participating, they will expect: 1) To be listed in the provider directory. 2) Non-payment of services rendered. 3) Full reimbursement for charges submitted.
Who is the CEO of Viva health?
Brad RollowBrad Rollow serves as the CEO / President of VIVA Health, Inc.
What is Viva UAB?
Since we started in 1995, Viva Health has grown to be one of the largest health plans in the State of Alabama. Viva Health is a Member of the UAB Health System. As a member of Viva UAB, you have access to UAB Health System, including Medical West for primary care, OB/GYN, and other health care services.
Is Viva good health insurance?
About Viva Health The company are an affiliate of the University of Alabama at Birmingham (UAB) health system. The Centers for Medicare & Medicaid Services (CMS) give all Viva Health Advantage plans 4.5 stars out of a possible 5 stars, using their five-star quality rating system.
Does UAB own Viva?
Managed Care Expertise Managed by professionals with years in the health care industry, Viva Health is also part of the renowned University of Alabama at Birmingham (UAB) Health System.
How many members does Viva Health have?
100,000 membersFounded in 1995, Viva Health is now the preferred healthcare provider for hundreds of Alabama companies and more than 100,000 members and growing.
What are the consequences of non participation with Medicare?
Non-participating providers can charge up to 15% more than Medicare's approved amount for the cost of services you receive (known as the limiting charge). This means you are responsible for up to 35% (20% coinsurance + 15% limiting charge) of Medicare's approved amount for covered services.
Can I bill Medicare for non covered services?
Under Medicare rules, it may be possible for a physician to bill the patient for services that Medicare does not cover. If a patient requests a service that Medicare does not consider medically reasonable and necessary, the payer's website should be checked for coverage information on the service.
Can a doctor charge more than Medicare allows?
A doctor is allowed to charge up to 15% more than the allowed Medicare rate and STILL remain "in-network" with Medicare. Some doctors accept the Medicare rate while others choose to charge up to the 15% additional amount.
Prior Authorization Update
In an effort to relieve some of the administrative burdens of our participating provider's offices, Viva Health has recently made some changes to the prior authorization (PA) requirements for certain procedures/CPT codes. Click here for details.
Viva Health COVERAGE POLICIES AND CRITERIA
The Viva Health Coverage Policies and Criteria contain Policies approved by Viva. Policies are based upon criteria from the Centers of Medicare & Medicaid Services (CMS), CMS approved drug compendia, or scientific evidence of merit for a particular medication.
Forms
Please fax Medicare Coverage Determination form (s) to Viva Medicare at 205-449-2465 on Medicare Part D drug (s) that will be filled at a dispensing pharmacy. Please fax Commercial Coverage Determination form (s) to Viva Health at 205-872-0458 for other drug (s) that will be filled at a dispensing pharmacy.
FORMULARY INFORMATION LIST
Compound drugs except when used for medically accepted indications that are supported by citations in standard reference compendia for the specific route of administration being prescribed. Only National Drug Codes (NDCs) for FDA approved prescription drug products are covered.
How to contact viva health?
If you have any changes, please email [email protected] or call Viva Health Customer Service at (205) 558-7474 or 800-294-7780. We will then update your information on our website.
When will Viva Health start a step therapy program?
Medical Preferred Drug Program with Step Therapy. Effective January 1, 2021, Viva Health is adding a Medical Preferred Drug Program with Step Therapy requirements for our Commercial Lines of Business. Click here for information about the program.
How long does it take to file a Medicare claim?
Effective March 1st, 2018, Coordination of Benefits claims for all lines of business (i.e., Commercial, Medicare) must be filed within eighteen months from the date of service in order to be considered for secondary payment.
Can Viva Health HCFA be filed electronically?
Coordination of Benefits Update. Viva Health is proud to announce secondary HCFA and UB claims can now be filed electronically for all Commercial , Medicare, and Drummond lines of business. If you have any questions, please feel free to contact our Provider Customer Service department directly at (205) 558-7474.
Does Viva Health have a PA?
In an effort to relieve some of the administrative burdens of our participating provider’s offices, Viva Health has recently made some changes to the prior authorization (PA) requirements for certain procedures/CPT codes . Click here for details.
Does Viva Medicare require a referral?
Effective 7/1/20 Viva Medicare members will no longer be required to have a Primary Care Physician referral in order to see a Pain Management physician. Here is an updated copy of our 2020 Provider Reference Guide listing the services that require a prior authorization. Click here to view.
Who must prescribe MRI?
These requirements include the following criteria: The MRI must be prescribed by your doctor or health care provider as part of the treatment for a medical issue. All parties involved in the procedure, (i.e. the doctor who prescribes the. MRI and the provider administering the MRI) must accept Medicare assignment.
What is the Medicare deductible for MRI?
Medicare coverage takes care of 80 percent of the authorized costs, but you will be responsible for paying the Part B deductible. For 2019, the deductible is $185.00.
What is an MRI scan?
An MRI scan is a painless and non-invasive exam that provides invaluable diagnostic information helping your physician give you optimum care. If you are enrolled in a Medicare Advantage plan, check with your plan directly to find out your exact costs for an MRI. Related articles: Medicare Part C.
What is an MRI?
An MRI helps diagnose certain conditions such as stroke, brain injury or aneurysm, or multiple sclerosis. It also helps physicians detect tumors or other abnormalities in organs, bones, and joints. If your doctor suggests that you have an MRI scan, you need to know whether your Medicare insurance plan covers the cost.
How much does an MRI cost?
In the United States, the average cost of an MRI is around $2,600.00. Prices can range greatly, between a few hundred to several thousand dollars. Original Medicare Part B does take care of 80 percent of the final cost, but that means you still must pay 20 percent out-of-pocket, in most cases.
What is the deductible for a 2019 scan?
For 2019, the deductible is $185.00. Even if you have Medicare Part B or are enrolled in a Medicare Advantage plan, you must meet some additional requirements for Medicare to pay for the cost of the scan. These requirements include the following criteria:
When do you have to be 65 to get Medicare?
Most people automatically are enrolled in Part A when they turn 65 as long as they paid taxes while working for a certain period of time.