VBID Model Hospice Benefit Component Participating Plans

VBID Model Hospice Benefit Component Quick Links:

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Under the Value-Based Insurance Design (VBID) Model, in Calendar Year (CY) 2023, fifteen Medicare Advantage Organizations (MAOs) will participate in the Hospice Benefit Component, offering 119 plan benefit packages (PBPs).

Note:

A downloadable list of PBPs with service area and comprehensive contact information can be found here.

 

Highlighted Contacts for MAOs Participating in the Hospice Benefit Component in CY 2023

  • Cambia Health Solutions with plans in select counties in OR, UT, and WA
  • Catholic Health Care Systems (ArchCare) with plans in select counties in NY
    • Hospice Network Administrative Contact: Victor Fama; (e): vfama@archcare.org; (p): 646-584-7984
  • CVS with plans in select counties in OH and PA
    • Hospice Network Administrative Contact: Sara Rose Mollitor; (e): MollitorS@aetna.com; (p): 202-559-8234
  • Elevance Health (MMM Healthcare, LLC) with plans in select counties in PR
  • Guidewell with plans in select counties in PR
    • Primary: Myra M. Velez Plumey, (e): myra.velez@ssspr.com; (p): 787-749-4949 ext. 832-6354
    • Secondary: Provider’s Call Center: 1-855-886-7474
  • Hawaii Medical Service Association with plans in select counties in HI
  • Highmark Health with plans in select counties in PA
  • Humana Inc. with plans in select counties in CO, FL, GA, IN, KY, OH, VA, and WI
  • Kaiser Foundation Health Plan, Inc. with plans in select counties in CA
    • There are two steps to submit notices and claims for Kaiser Permanente Senior Advantage Ventura County Plan (H0524-034 and H0524-083) members:
      • Send the Notice of Election to KP-NOE@kp.org; and 
      • Submit claims via the Electronic Data Interchange (EDI) process. To sign up for EDI, please contact your clearinghouse and provide the appropriate payer ID.
    • Where do you get more information for Kaiser Foundation Health Plans, Inc?
      • For questions regarding member benefits and/or eligibility, please call Kaiser Permanente Member Services at 1-800-443-0815.
      • For questions regarding claims payment and/or to receive a Kaiser Permanente Provider Payment Dispute Resolution Form, please call Kaiser Permanente Claims Services at 1-800-390-3510
    • For all other questions regarding hospice:
  • Louisiana Health Services and Indemnity Company with plans in select counties in AR, LA, and MS
  • Marquis Advantage, Inc. dba AgeRight Advantage Health Plan in select counties in OR
  • Presbyterian Healthcare Services (PHS) with plans in select counties in NM
  • SCAN Group with SCAN Health Plan in select counties in CA
    • Participating SCAN Health Plan: SCAN Embrace I-SNP plans in CA: H5425-086, H5425-087 and H5425-091.
    • For information on eligibility, claims/NOE submission, TCC benefits, and supplemental benefits, visit: https://www.scanhealthplan.com/vbid
    • Providers may check member eligibility, register for SCAN’s clearinghouse Office Ally, and access other provider resources by visiting: https://www.scanhealthplan.com/providers
    • For all VBID hospice inquiries, contact:
    • For urgent clinical inquiries, please contact the SCAN Mobile Care Team care management team by phone at (855) 828-7226.
  • UnitedHealth Group with plans in select counties in AL, IL, OK, and TX
    • UHC Hospice Network Administrative Contact
    • Clinical – Provider/Patient Support Contact (Alabama, Illinois, Oklahoma)
      • Primary: Mindy Stewart-Coffee
      • Patient/Pre-Hospice Consult (p): 833-753-2970
      • Provider Clinical Inquiries (Transitional Concurrent Care) (p): 833-753-2970 (e): Support@envoycareadvocates.com
    • Clinical – Provider/Patient Support Contact (Texas)
      • Primary: Elizabeth Lamb, (e): VBIDCCHospice@wellmed.net
      • Patient/Pre-Hospice Consult (p): 361-252-6978
      • Provider Clinical Inquiries (Transitional Concurrent Care) (p): 361-252-6978
  • Visiting Nurse Service of New York (VNSNY) with plans in select counties in NY

Hospice Network Administrative Contact for MAO Participating in CY 2022 ONLY or CY 2021 and CY 2022 ONLY

  • AvMed with plans in select counties in FL
    • Hospice Network Administrative Contact: Joseph Young, Director, Hospital and Ancillary Contracting; (e): joseph.young@avmed.org; (p): 305-671-5437, ext. 27300
    • Secondary: Jacqueline Crews; (e): Jackie.crews@avmed.org; (p): 352-337-8832
  • Intermountain Health Care, Inc. with plans in select counties in ID and UT

Hospice Network Administrative Contact for MAO Participating in CY 2021 ONLY

Key:

(e): Email address

(p): Business phone number

Last updated on:
05/26/2023