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Our provider training
At Aetna Assure Premier Plus (HMO D-SNP), we make sure our providers have the right tools and resources to take care of our members. Below is information to help make your transition to our team as smooth and easy as possible. You’ll also find information about required compliance trainings that you and your staff must complete.
New provider orientation
New provider orientation
We see you as our ally in providing high-quality health care services to our Aetna Assure Premier Plus (HMO D-SNP) members. As you strive to deliver the best care possible and to better understand the health plan, we hope you’ll take advantage of all the resources we provide. For providers of Aetna Assure Premier Plus (HMO D-SNP), see our Provider Orientations (PDF). If you are an LTSS provider, see our LTSS Provider Presentation (PDF)
Following your initial provider orientation, we provide a variety of educational forums for ongoing provider training and education. These include:
- Routine visits to your office
- Group or individualized training sessions on select topics. Some examples include: Claims coding, Appointment availability standards, Member benefits, Aetna Assure Premier Plus (HMO D-SNP) website navigation and periodic provider newsletters and bullenteins containing updates and reminders.
We will help you learn important information about the programs and services we provide. You’ll learn more about our:
- Grievance system
- Managed care services
- Policies and procedures
- Member rights and responsibilities
- Cultural competency
- Health education requirements standards
Cultural competency
Cultural competency
Providers should be educated on the importance of cultural competency. You can watch the video at this link to learn more.
Once complete, email us at NJ_FIDESNP_Providers@aetna.com to let us know you’ve viewed the training video, so we can identify your office as trained in cultural competency.
CMS-required compliance training for all providers
Dual Eligible Special Needs Plans (D-SNPs) Model of Care training
Medicare providers who care for D-SNP members are required to complete compliance training each year. The Centers for Medicare & Medicaid Services (CMS) requires it.
This training is mandatory. All network providers and their employees who serve Aetna Assure Premier Plus (HMO D-SNP) members must complete the training. Training must be done:
- When a new provider or employee is hired
- Each calendar year (but no later than December 31)
Note: You don’t have to send us an attestation of training completion. But you could be audited by CMS or us. For that reason, please be sure to keep a record of completion.
Where can I take the course?
The Dual Eligible Special Needs Plans (D-SNPs) Model of Care training is available online.
You can find the training here (PDF)
Thank you for the care you give our D-SNP members.
Additional training and resources
First tier, downstream and related entities (FDR) program and compliance requirements
Who should complete FDR training? (PDF)
Centers for Medicare & Medicaid Services (CMS) requirements and training for FDR entities
CMS requirements for downstream entities (PDF)
CMS Parts C and D general compliance training (PDF)
CMS fraud, waste and abuse training (PDF)
Attestations
Medicare compliance FDR attestations
Offshore services attestation (PDF)
Tools for remaining compliant
Fraud, waste and abuse training log example (PDF)
Checking and reporting compliance and fraud
How to report ethics and compliance concerns (PDF)
U.S. General Services Administration (GSA) and SAM exclusion list
Stay up-to-date with the latest FDR newletters
Have questions?
If you need guidance on which trainings you must complete or have questions about this page, please call Provider Services at 1-844-362-0934 (TTY: 711).