Mainstay bills Medicare directly. There's nothing for your team to bill or document. Each month we send you a report to review, covering the patients we served and time by program.

Mainstay bills Medicare directly, and the vast majority of patients receive this at no cost. Patients with a supplemental (Medigap) plan or Medicare Advantage often pay nothing. We also offer a financial assistance policy for patients who need help with cost sharing. Before anyone enrolls, our clinician talks them through the program and any cost sharing, answers their questions, and records their consent.

No. The service is funded by Medicare's PIN and CHI programs, at no cost to the practice.

PIN and CHI focus on non-clinical barriers, so they usually sit alongside care management programs you already run. We'll review your current services with you so time isn't counted twice and only one practice bills PIN for a patient in a given month.

PIN covers patients with one serious, high-risk condition, such as advanced chronic kidney disease. CHI covers patients whose social needs, like transport or cost, get in the way of treatment. You approve the eligibility list before anyone is enrolled.

Our team only works on non-clinical, social barriers to care. We proactively let the other physicians involved in a patient's care know that we're supporting them, and which parts of the care plan our navigators are helping with. Clinical questions always go back to the treating physician.

Clinical decisions, prescriptions, prior authorization submissions and appeals, and the care plan. Clinical questions are always routed back to your practice.

Approve the patient list, have a physician or MA mention us to patients, and tell us when something changes. No new workflows and no added headcount.

We sign a business associate agreement (BAA) with your practice before we see any patient information, and handle all data in line with HIPAA.