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ACA FAQs Regarding Participating vs. Non-Participating Medicare Status

ACA receives a multitude of questions regarding Medicare and the physician fee schedule. Following are answers to some of the most frequently asked questions:
Q: Can I just ignore the fee schedule? I’m non-participating anyway.
Q: Who do I contact for the latest information on the fee schedule? It's always so confusing at the end of the year.
Q: Could you provide a complete explanation of par fee allowance, non-par fee allowance and limiting charge?
Q: Can I change my Medicare Participating status?

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Patients' Complaints to the PA Insurance Department (PID)

PCA members should be prepared to give their patients instructions and forms for filing complaints with the Insurance Department (link to PID patient complaint form, click here). When patients are expected to be financially responsible for services that may be denied by health insurers and/or their intermediaries, they will most certainly want to complain to someone. PCA President Raymond Benedetto, DC, commented, “The PA Insurance Department has clearly requested PCA to direct patients and their complaints to the PA Insurance Department, so that’s what PCA members should do. Our members are currently serving as the voice for many of their patients, so it is extremely important that members direct their patients to the PA Department of Insurance.”

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PA Department of Human Services

Provider Resources

 

US Department of Health and Human Services

Provider Resources

 

Bureau of Workers' Compensation

Click Here to access the latest news and information on Workers' compensation.

 

Health Insurance Exchange

www.PAHealthOptions.com

 

Health Insurance Resources

 

Aetna's Health Care Professionals Resources 

Click Here to access Aetna's Health Care Professionals Resources page. You may have to login to access certain parts of this website.

Click Here to login to NaviNet to access Aetna's Fee Schedule.

 

Centers for Medicare & Medicaid Services

Click here to go to CMS website.

Click Here to access Medicare Part B Fee Schedule

 

Cigna's Resources for Health Care Professionals

Click Here to access Cigna's Resource page for Health Care Professionals. You may need to login to access certain parts of this website.

 

Highmark's Provider Resource Center

In order to get to the Provider Resource Center (PRC), you must CLICK HERE first. Once Highmark’s homepage is open, you will then find the PRC link, and many other helpful links, under the Helpful Links category. Highmark may require login information to access certain parts of this website.

 

US Deptartment of Veterans Affairs

www.va.gov

 

Publications

Dynamic Chiropractic 

ChiroAccess – research

Chiropractic Economics

 

Legislative Resources

Write to your U.S. Congressman

Find your legislator

PA State House of Representatives Helpful Resources

PA State Senate Helpful Resources

Find PA State Bills & Resolutions

How to read Legislative Bills

Pennsylvania General Assembly

ChiroVoice.org

AdjustTheVote.org

Current ACA Action Alerts

PA State Board of Chiropractic