Medical Savings Account

The Select Health Group Medical Savings Account (MSA) is a unique and simple, employer-offered plan operating more like Original Medicare than other MA plans. Select Health utilizes Fenyx Health, the nation’s MSA leader, to administer our MSA plan.

Why is a MSA better for providers?

• Reduce billing and recovery efforts — The Select Health Group MSA pays 100% of the Medicare-allowed amount, so no additional billing is required.
• No additional prior authorizations or referrals beyond those required by Medicare.
• No contract required to see patients or bill/receive payment from the MSA.
• Simple reimbursement — the Select Health Group MSA pays as Original  Medicare pays, using Medicare’s payment schedules and benefit/medical policies.
• No credentialing hassles.

How do I get MSA support?

The Select Health Group MSA is supported exclusively by Fenyx Health, the nation’s MSA leader. To get support, contact Select Health Group MSA directly using these channels:

• Call: 855-511-1514
• Email: providers@selecthealthgroupmsa.org

How do I submit a MSA claim?

MSA plans are mandated to pay the lesser of billed charges or Medicare-allowed amount. Submitting a claim for care is easy, using the following:

• Online portal: portal.smartdatastream.us (payer ID 83309)
• Mail: PO Box 97, Orange, CA 92856

How do I get paid after submitting a claim?

After you submit a claim (no contract required), we process it and notify all parties of payment responsibility. Here are some sample scenarios:

Scenario: Expense is covered and deductible is not met.
Action: We pay you the Medicare-allowed amount on behalf of the patient, then bill the patient for their liability.

Scenario: Expense is covered and deductible is met.
Action: We pay you the Medicare-allowed amount.

Scenario: Expense is not covered, regardless of deductible status.
Action: You bill the patient, and they pay you.

How do reimbursements work for covered services/items?

We cover the same A/B services and items as Medicare, with reimbursement depending on your Medicare participation status:

• Medicare-participating: The lesser of billed charges or 100% of the Medicare-allowed amount. When you agree to see the patient and bill our plan, you accept Medicare’s rates and are not permitted to balance bill the patient.
• Medicare non-participating: The lesser of billed charges or 95% of the Medicare-allowed amount. Balance billing up to the limiting charge where allowed by state law is permitted. Balance billing or excess charges are not covered by the plan.
• Medicare opt-out: As your billing is not controlled or limited by Medicare, you enter into a private contract with the patient. No charges are covered, and no reimbursements are made by the plan.

We use Medicare’s fee schedules and pricing methodologies. If your practice/facility has special, non-public rates established with your MAC, send your rate letter(s) to providers@selecthealthgroupmsa.org so we can reprice the claim correctly.

CMS designed MSAs with access to all Medicare providers and most accept the MSA. While you can choose at each visit to see the patient or not, please speak with us if you have concerns. We want to find an agreeable arrangement for both of you.

Select Health Group MSA is an MSA plan with a Medicare contract held and administered by Fenyx Health Insurance Company. Enrollment in the Plan depends on contract renewal.