Fast, Accurate & Full Payments

High-deductible without the risk

We finance members’ Medicare A/B liabilities under the deductible and pay providers on their behalf

Fewer Admin Hassles

No contracts or care coordination

No referrals, prior authorizations, network contracts or credentialing

Bonus Programs

Get more out of our MSA

Reward clinical engagement, support local employers and tailor steerage

Removing Non-payment Risk

How Payment Works with our MSA

We get it. High-deductible plans have a bad history of non-payment risk.

We designed our MSA to be different. Our special financing program allows us to pay providers directly for member A/B liabilities under their deductible. So, you receive payment quickly, accurately and in-full.

1) See Our Member

CMS designed MSAs with access to all Medicare providers, for beneficiary protection and choice.

Most providers, including the nation’s largest systems, accept the MSA.

2) Submit Your Claim

No contract required

There’s no contracting hassles with the MSA. Submit your claim to us just like you would an out-of-network PPO claim. Easy.

3) We Process Your Claim

We process your claim and notify all parties of any repricing and payment responsibilities.

If the expense is…

Plan-covered and deductible is not met

We pay you on the patient’s behalf, then bill the patient.

We pay you.

You bill the patient and the patient pays you. If you have difficulties receiving payment, please speak with us.

CMS requires us to pay as Medicare pays for plan-covered charges. Reimbursement depends on your Medicare status:

Medicare Participating & Accepting Providers

The lesser of billed charges or 100% Medicare-allowed amount. Interested in making more? Please speak with us about our bonus programs.

95% of the Medicare-allowable amount, with balance billing of the patient, where allowed by state law, up to 15% of the non-participating Medicare-allowable amount. Balance billing or excess charges are not covered by the plan.

As your billing is not controlled or limited by Medicare, this becomes a private contract between you and the patient. No charges are covered by the plan.

You can choose whether or not to see the patient at each visit. If you have any concerns about seeing a patient with Fenyx Health Group MSA, please speak with us – we want to find an agreeable arrangement for you both.

What is an MSA?

  • Acronym for Medical Savings Account

  • One type of Medicare Advantage plan

  • Designed by CMS with clinical access to all Medicare providers and reimbursement like Original Medicare

  • Covers Parts A and B expenses

  • Similar in concept to an HSA, except the health plan funds the MSA account

  • Prohibited by law from restricting members to a network

  • Accepted by most providers, including many of the largest and renowned health care systems

  • Does not require a contract for claims submission (like an out-of-network PPO claim)

Make the MSA Work for You

Clinical Engagement at Any Level

Accept MSA Plans

#1

MSAs are increasingly available in the individual market.

As we look to enter the group market with sizable membership, there’s benefit for you in assuring your market that MSAs are accepted in your system.

We Pay the Interest

#2
Allow Fenyx Health to finance the interest charge for plan-covered expenses billed through your preferred financing vendor.

Financing via Fenyx

#3

Don’t have a financing vendor? We can do it.

For plan-covered expenses under the deductible, we’ll pay you in full and then bill our member.

Gift Card Incentives

#4
Steer and provide incentives for clinical engagement with gift cards (system-branded or otherwise).

Add an HRA

#5

Work with your local employer groups to support clinical engagement by sponsoring a Health Reimbursement Account (HRA).

Quality Bonus

#6
Receive a quality bonus on top of your Medicare-allowed payment by meeting clinical goals for your imputed patient population.

Discount Plus Bonus

#7
Offer below Medicare-allowed rates to steer, and we will make you whole and apply a bonus when clinical goals are met.

Take Some Risk

#8
With the alignment of clinical incentives, the MSA is an interesting option for taking risk.

Upside, downside and full-risk models can be structured.

Quota Share

#9

Leverage your brand dominance and white label our Group MSA as your own.

Offer it to your retirees and current commercial clients.

Your call and service, or ours.

Interested in Learning More?

#10

Please reach out to us at providers@fenyxhealth.com and we’ll set up some time to talk further.

Get in Touch with Us

Ready to Support You

Email

providers@fenyxhealth.com

Mail

PO Box 135, Winfield, PA 17889

Phone

(800) 350-6626

Email

providers@fenyxhealth.com

Mail

PO Box 135, Winfield, PA 17889

Phone

(800) 350-6626