Medicare Advantage at Rula

Background

Rula began accepting therapy patients who were insured with Cedars-Sinai Medicare Advantage (MA) insurance through a Blue Shield plan on 10/9/2023.

Psych services were added a few months later.

Program expansion

Rula will now accept therapy-only clients covered by Kaiser Permanente: Southern California’s Medicare Advantage Plan.

On the Medicare Population

Medicare beneficiaries primarily consist of people over the age of 65 but also include some people who are under 65 with certain conditions or disabilities. These patients can encounter a limited pool of providers as not all providers are eligible to treat Medicare beneficiaries or bill Medicare for services. Expanding our services to this patient population is a continuation of Rula’s mission to make mental healthcare work for everyone. Thank you for working with us to provide critical care to these patients!

Psych Referrals

Rula has expanded therapy and psych care to patients in California with Cedars-Sinai Medicare Advantage (MA) insurance through a Blue Shield plan. Inform your patients who are seeking to add psych that they must make an additional request for a psych referral from Cedars-Sinai. We are currently not able to offer psych for Kaiser SoCal MA patients.

Duration of care

These patients need referrals from their insurance carrier in order to start treatment with Rula. After signing up, they receive an initial referral for a designated number of sessions:

  • Cedars-Sinai Medicare Advantage patients receive up to 12 sessions
  • Kaiser SoCal Medicare Advantage patients receive up to 16 sessions


What’s not in-network


At this time, all other traditional Medicare, Medicare Advantage, and Medicaid plans outside of Cedar-Sinai in California and Kaiser Permanente in Southern California. Patients with Medicare, Medicare Advantage, and Medicaid who are not in-network should be referred back to their insurer for in-network providers.

FAQs

Who can see Medicare Advantage clients?

All providers who wish to see these patients at Rula must log in and complete the Fraud, Waste, and Abuse (FWA) course in Northpass before doing so. See this article for more information: Medicare requirements.

Additionally, providers may not see these clients if they have "Opted-Out" of Medicare

 

How much will I get paid to see these clients?

Compensation will be the same when treating Medicare Advantage as it is for commercial clients. If you have additional payment questions, please reach out to the Accounts Payable team at AP@rula.com.


Will I still get paid for missed appointments?

Although Medicare Advantage clients are not charged no-show fees, Rula will still pay therapists when this happens. Simply fill out the missed appointment note as you normally would!


Medicare terms

Click here to review the terms for Medicare Advantage at Rula.

Was this article helpful?

1 out of 1 found this helpful