Accept Medicare. Say “Yes” More Often.
You support seniors.
We handle everything else.
Sign up with Umbra, as an individual or as your advocacy group
Bring your Medicare clients to the Umbra platform
Umbra verifies client eligibility
An Umbra-affiliated doctor or nurse practitioner assesses the client in a telehealth visit
You develop an advocacy care plan and provide services to the client
“Umbra bills Medicare and pays you for qualified services you provide
Umbra maintains HIPAA-compliant platform for charting, telehealth, and billing
How it Works:
- Fill out this form
- Speak with the Umbra team
- Complete a background check and Umbra training
- Start referring your clients so Umbra can confirm their eligibility
- Grow your practice with Medicare clients
Ready to Accept Medicare Clients?
Medicare Advocate Partnership
FREQUENTLY ASKED QUESTIONS
No. You provide advocacy services as part of our practice. We bill Medicare directly through our own practice and a nationwide network of affiliated medical practices, according to state rules.
No. You can join our network as a participating independent contractor for no cost. You will be paid for qualified, documented service units equivalent to $42/hour.
Specific codes will vary based on the services provided and the CMS rules that apply. Below are the codes we will most likely draw from.
Principal Illness Navigation
G0023 - 60 minutes/calendar month
G0024 - Additional 30 minutes/calendar month
Community Health Integration
G0019 - First 60 minutes
G0022 - Additional 30 minutes after initial 60
Umbra handles all the billing. We provide a HIPAA-compliant platform for Advocates and Supervising Providers to document the services you provide. We have built out our platform specifically for these services to support your work as seamlessly as possible.
We will provide you with training on what services are covered and how to document properly to meet Medicare standards. Umbra submits claims to Medicare and pays you for valid, qualified, correctly documented time, regardless of the claim outcome.
Valid, qualified time spent on work that you do with the patient or on their behalf is billable under PIN and CHI services, provided the documentation supports the amount of service and the services’ medical necessity.
General admin work, travel time, and services outside the scope of PIN or CHI codes are not billable.
To qualify for PIN services, beneficiaries must have at least one serious, high-risk condition that is expected to last 3 months or more and that places them at significant risk of hospitalization, nursing home placement, functional decline, or death.
To qualify for CHI services, beneficiaries must have an unmet social determinant of health (SDOH), or non-medical need, that significantly limits their ability to get proper diagnosis and/or treatment.
These services can be provided in person or virtually. Medicare does not pay for travel time.
If we determine that a client you refer is ineligible for Medicare-covered advocacy services, you may choose to work with them independently via a private pay agreement.
Umbra does offer discounted private pay options to clients with financial hardship. You can choose to work with the client under those terms or refer them to one of our advocates who takes hardship cases for a reduced fee.
No matter what, we will seek to help clients get the support they need.