Question

if a member of a medicare cost plan receives care from a non - network provider:
a. the original medicare plan does not cover the services
b. the original medicare plan covers the services
c. a special report must be attached to the claim
d. preauthorization must be obtained from a mac

Explanation:

When a member of a Medicare Cost Plan receives care from a non - network provider, if the original Medicare plan does not cover the services, certain rules apply. A special report is not required to be attached to the claim in all cases. Preauthorization from a MAC (Medicare Administrative Contractor) is not always the first step. And it is not about whether the original Medicare plan covers the services in terms of the general situation for non - network care in this context.

Answer:

A. the original Medicare plan does not cover the services