This article is for providers who care for our Medicare Advantage members
As a reminder, our existing Medicare Advantage Management medical policy applies to providers who care for our Medicare Advantage members.
CMS requires us to use its National Coverage Determination (NCD) rules for Medicare Advantage members. We also use the Massachusetts Medicare Administrative Contractor's Local Coverage Determination (LCD) policies.
When neither NCD nor LCD guidelines exist, we follow our Blue Cross Blue Shield of Massachusetts medical policies for Medicare Advantage members.
You can avoid claim denials or post-payment recoveries by consulting our medical policies before caring for our Medicare Advantage members.
Related medical policy
Medical
policy 132, Medicare Advantage Management
Questions?
If you have any questions, please call Network Management and Credentialing Services at 1-800-316-BLUE (2583). As always, thank you for the care you provide to our members.
MPC_060424-1P-1