You must tell her that a Private Fee-for-Service (PFFS) plan may affect her access to services to vary the provider's pay rates solely based on the provider's specialty or location or to increase usage of certain preventive or sorting
<h3>What is the Private Fee-For-Service (PFFS) plan?</h3>
A Private Fee-For-Service (PFFS) plan is a Medicare Advantage (MA) health plan offered by a state-licensed risk entity that has an annual contract with the Centers for Medicare & Medicaid Services (CMS) to provide all your Medicare benefits, in addition to any additional benefits the company chooses to provide, to beneficiaries. The PFFS plan:
• Pays providers on a fee-for-service basis without putting providers at financial risk
• Vary provider payment rates solely based on provider specialty or location or to increase utilization of certain preventive or screening services
• Does not restrict participants' choice among providers legally authorized to provide services and accept the plan's payment terms and
• Does not allow the use of prior authorization or notification.
With this information, we can conclude that you must tell her that a Private Fee-for-Service (PFFS) plan may affect her access to services to vary the provider's pay rates solely based on the provider's specialty or location or to increase usage of certain preventive or sorting
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