Private Fee-for-Service

As a provider, you can access a PFFS plan finder, terms and conditions, and payment and reimbursement information.

Select Advantage Terms and Conditions

Payment Methodology Information

Reimbursement Grid

Plan Finder

To view Terms and Conditions for out-of-area beneficiary’s home plan, go to the Plan Finder.

Forms

• Notice of Medicare Non-coverage (NOMNC) form
• Detailed Explanation of Non-coverage (DENC) form
• Notice of Discharge and Medicare Appeal Rights (NODMAR) form
• Provider Appeals form