Re: Question about Medicare opt out/non-par

[Guest guest]

,

In order to be non-participating status, you have to have enrolled with Medicare. There is no other way patients will be reimbursed their portion of payment by Medicare.

Unfortunately, I have no idea what the answer is to the question of status if a physician has never enrolled in Medicare. I also have no idea who you would ask to get the correct answer, as I am pretty sure Medicare dose not know. I have posted on this issue before. It is unclear to me when the government claims to own physicians, as I now must opt out of Medicare every 2 years, or be involuntarily re- enrolled. Weird.

Durango, CO

Over the weekend, we had a little FP get together in the Pasadena area where IMPs, pre-IMPs and non-IMPS just chatted at an informal gathering at my house. I think it's good for the specialty and primary care in general to know our local colleagues, plus it helps spread the IMP message. Anyways, one of the questions that came up was: What do you do if you have never enrolled as a provider with Medicare? Are you a non-participating doctor or are you considered opted out? Do you have to enroll with Medicare just so you can opt out? Since this question may be relevant to others on the listserve, I thought I would post what I found out here.

From the American Psychiatric Association: http://pn.psychiatryonline.org/cgi/content/full/43/20/16

Q. I have never enrolled as a Medicare provider and would like to opt out of the program. When I contacted my Medicare carrier, I was told I had to enroll before I opted out. Is this true?

A. No. The Medicare carrier (or contractor) does need to be able to identify you, however, so you must provide your NPI, as well as your address, tax identification number, and medical license number. If you use the opt-out affidavit posted on APA's Web site, you will provide the carrier with all the necessary information. The affidavit can be accessed at the bottom of this Web page: <www.psych.org/MainMenu/PsychiatricPractice/MedicareMedicaid/OptingOutofMedicare.aspx>.

-----------------------------

This is from AAFP's web site:

http://www.aafp.org/online/en/home/practicemgt/mcareoptions.html

There are basically three Medicare contractual options for physicians. Physicians may sign a participating (PAR) agreement and accept Medicare's allowed charge as payment in full for all of their Medicare patients. They may elect to be a non-PAR physician, which permits them to make assignment decisions on a case-by-case basis and to bill patients for more than the Medicare allowance for unassigned claims. Or they may become a private contracting physician, agreeing to bill patients directly and forego any payments from Medicare to their patients or themselves.

Based on the above, my interpretation (which may not be correct) is that you have to choose one of these three options. If you have never enrolled in Medicare and you do not enroll as a partipating provider and you do not formally opt out of Medicare, then you are automatically choosing the 3rd option and you are a non-participating provider and subject to the rules associated with that status, including limits on how much you may charge a patient.

Seto

South Pasadena, CA

[Guest guest]

,

In order to be non-participating status, you have to have enrolled with Medicare. There is no other way patients will be reimbursed their portion of payment by Medicare.

Unfortunately, I have no idea what the answer is to the question of status if a physician has never enrolled in Medicare. I also have no idea who you would ask to get the correct answer, as I am pretty sure Medicare dose not know. I have posted on this issue before. It is unclear to me when the government claims to own physicians, as I now must opt out of Medicare every 2 years, or be involuntarily re- enrolled. Weird.

Durango, CO

Over the weekend, we had a little FP get together in the Pasadena area where IMPs, pre-IMPs and non-IMPS just chatted at an informal gathering at my house. I think it's good for the specialty and primary care in general to know our local colleagues, plus it helps spread the IMP message. Anyways, one of the questions that came up was: What do you do if you have never enrolled as a provider with Medicare? Are you a non-participating doctor or are you considered opted out? Do you have to enroll with Medicare just so you can opt out? Since this question may be relevant to others on the listserve, I thought I would post what I found out here.

From the American Psychiatric Association: http://pn.psychiatryonline.org/cgi/content/full/43/20/16

Q. I have never enrolled as a Medicare provider and would like to opt out of the program. When I contacted my Medicare carrier, I was told I had to enroll before I opted out. Is this true?

A. No. The Medicare carrier (or contractor) does need to be able to identify you, however, so you must provide your NPI, as well as your address, tax identification number, and medical license number. If you use the opt-out affidavit posted on APA's Web site, you will provide the carrier with all the necessary information. The affidavit can be accessed at the bottom of this Web page: <www.psych.org/MainMenu/PsychiatricPractice/MedicareMedicaid/OptingOutofMedicare.aspx>.

-----------------------------

This is from AAFP's web site:

http://www.aafp.org/online/en/home/practicemgt/mcareoptions.html

There are basically three Medicare contractual options for physicians. Physicians may sign a participating (PAR) agreement and accept Medicare's allowed charge as payment in full for all of their Medicare patients. They may elect to be a non-PAR physician, which permits them to make assignment decisions on a case-by-case basis and to bill patients for more than the Medicare allowance for unassigned claims. Or they may become a private contracting physician, agreeing to bill patients directly and forego any payments from Medicare to their patients or themselves.

Based on the above, my interpretation (which may not be correct) is that you have to choose one of these three options. If you have never enrolled in Medicare and you do not enroll as a partipating provider and you do not formally opt out of Medicare, then you are automatically choosing the 3rd option and you are a non-participating provider and subject to the rules associated with that status, including limits on how much you may charge a patient.

Seto

South Pasadena, CA

[Guest guest]

, Good for you doing networking with local family docs.

and , I think I was enrolled in Medicare as a

third year resident by my residency (I’m not completely sure; may have

been my first job, but I think I got my UPIN while still in residency), so you

may be enrolled without actually having filled out the paperwork yourself if

anyone has billed Medicare with you listed as the provider. But, of

course, this doesn’t speak to the question raises.

Sharon

From:

[mailto: ] On Behalf Of

Sent: Sunday, November 02, 2008 3:04 PM

To:

Subject: Re: Question about Medicare opt

out/non-par

,

In order to be non-participating status, you have to have

enrolled with Medicare. There is no other way patients will be reimbursed

their portion of payment by Medicare.

Unfortunately, I have no idea what the answer is to the

question of status if a physician has never enrolled in Medicare. I also

have no idea who you would ask to get the correct answer, as I am pretty sure

Medicare dose not know. I have posted on this issue before. It is

unclear to me when the government claims to own physicians, as I now must opt

out of Medicare every 2 years, or be involuntarily re- enrolled. Weird.

Durango, CO

Over the weekend, we had a little

FP get together in the Pasadena area where IMPs, pre-IMPs and non-IMPS just

chatted at an informal gathering at my house. I think it's good for the

specialty and primary care in general to know our local colleagues, plus it

helps spread the IMP message. Anyways, one of the questions that came up was:

What do you do if you have never enrolled as a provider with Medicare? Are you

a non-participating doctor or are you considered opted out? Do you have to

enroll with Medicare just so you can opt out? Since this question may

be relevant to others on the listserve, I thought I would post what I

found out here.

From the American Psychiatric

Association: http://pn.psychiatryonline.org/cgi/content/full/43/20/16

Q. I

have never enrolled as a Medicare provider and would like to opt out of

the program. When I contacted my Medicare carrier, I was told I had to

enroll before I opted out. Is this true?

A. No.

The Medicare carrier (or contractor) does need to be able to identify you,

however, so you must provide your NPI, as well as your address, tax

identification number, and medical license number. If you use the opt-out

affidavit posted on APA's Web site, you will provide the carrier with all

the necessary information. The affidavit can be accessed at the bottom

of this Web page: <www.psych.org/MainMenu/PsychiatricPractice/MedicareMedicaid/OptingOutofMedicare.aspx>.

-----------------------------

This is from AAFP's web site:

http://www.aafp.org/online/en/home/practicemgt/mcareoptions.html

There are basically three Medicare

contractual options for physicians. Physicians may sign a participating (PAR)

agreement and accept Medicare's allowed charge as payment in full for all of

their Medicare patients. They may elect to be a non-PAR physician, which

permits them to make assignment decisions on a case-by-case basis and to bill

patients for more than the Medicare allowance for unassigned claims. Or they

may become a private contracting physician, agreeing to bill patients directly

and forego any payments from Medicare to their patients or themselves.

Based on the above, my

interpretation (which may not be correct) is that you have to choose one of

these three options. If you have never enrolled in Medicare and you do not

enroll as a partipating provider and you do not formally opt out of Medicare,

then you are automatically choosing the 3rd option and you are a

non-participating provider and subject to the rules associated with that

status, including limits on how much you may charge a patient.

Seto

South Pasadena, CA

[Guest guest]

, Good for you doing networking with local family docs.

and , I think I was enrolled in Medicare as a

third year resident by my residency (I’m not completely sure; may have

been my first job, but I think I got my UPIN while still in residency), so you

may be enrolled without actually having filled out the paperwork yourself if

anyone has billed Medicare with you listed as the provider. But, of

course, this doesn’t speak to the question raises.

Sharon

From:

[mailto: ] On Behalf Of

Sent: Sunday, November 02, 2008 3:04 PM

To:

Subject: Re: Question about Medicare opt

out/non-par

,

In order to be non-participating status, you have to have

enrolled with Medicare. There is no other way patients will be reimbursed

their portion of payment by Medicare.

Unfortunately, I have no idea what the answer is to the

question of status if a physician has never enrolled in Medicare. I also

have no idea who you would ask to get the correct answer, as I am pretty sure

Medicare dose not know. I have posted on this issue before. It is

unclear to me when the government claims to own physicians, as I now must opt

out of Medicare every 2 years, or be involuntarily re- enrolled. Weird.

Durango, CO

Over the weekend, we had a little

FP get together in the Pasadena area where IMPs, pre-IMPs and non-IMPS just

chatted at an informal gathering at my house. I think it's good for the

specialty and primary care in general to know our local colleagues, plus it

helps spread the IMP message. Anyways, one of the questions that came up was:

What do you do if you have never enrolled as a provider with Medicare? Are you

a non-participating doctor or are you considered opted out? Do you have to

enroll with Medicare just so you can opt out? Since this question may

be relevant to others on the listserve, I thought I would post what I

found out here.

From the American Psychiatric

Association: http://pn.psychiatryonline.org/cgi/content/full/43/20/16

Q. I

have never enrolled as a Medicare provider and would like to opt out of

the program. When I contacted my Medicare carrier, I was told I had to

enroll before I opted out. Is this true?

A. No.

The Medicare carrier (or contractor) does need to be able to identify you,

however, so you must provide your NPI, as well as your address, tax

identification number, and medical license number. If you use the opt-out

affidavit posted on APA's Web site, you will provide the carrier with all

the necessary information. The affidavit can be accessed at the bottom

of this Web page: <www.psych.org/MainMenu/PsychiatricPractice/MedicareMedicaid/OptingOutofMedicare.aspx>.

-----------------------------

This is from AAFP's web site:

http://www.aafp.org/online/en/home/practicemgt/mcareoptions.html

There are basically three Medicare

contractual options for physicians. Physicians may sign a participating (PAR)

agreement and accept Medicare's allowed charge as payment in full for all of

their Medicare patients. They may elect to be a non-PAR physician, which

permits them to make assignment decisions on a case-by-case basis and to bill

patients for more than the Medicare allowance for unassigned claims. Or they

may become a private contracting physician, agreeing to bill patients directly

and forego any payments from Medicare to their patients or themselves.

Based on the above, my

interpretation (which may not be correct) is that you have to choose one of

these three options. If you have never enrolled in Medicare and you do not

enroll as a partipating provider and you do not formally opt out of Medicare,

then you are automatically choosing the 3rd option and you are a

non-participating provider and subject to the rules associated with that

status, including limits on how much you may charge a patient.

Seto

South Pasadena, CA

[Guest guest]

,I agree it's weird because that means you would have to follow rules to which you have never agreed. I submitted this as a question to AAFP's Family Practice Management. Maybe they can shed some light on this. SetoSouth Pasadena, CA, In order to be non-participating status, you have to have enrolled with Medicare. There is no other way patients will be reimbursed their portion of payment by Medicare. Unfortunately, I have no idea what the answer is to the question of status if a physician has never enrolled in Medicare. I also have no idea who you would ask to get the correct answer, as I am pretty sure Medicare dose not know. I have posted on this issue before. It is unclear to me when the government claims to own physicians, as I now must opt out of Medicare every 2 years, or be involuntarily re- enrolled. Weird. Durango, COOver the weekend, we had a little FP get together in the Pasadena area where IMPs, pre-IMPs and non-IMPS just chatted at an informal gathering at my house. I think it's good for the specialty and primary care in general to know our local colleagues, plus it helps spread the IMP message. Anyways, one of the questions that came up was: What do you do if you have never enrolled as a provider with Medicare? Are you a non-participating doctor or are you considered opted out? Do you have to enroll with Medicare just so you can opt out? Since this question may be relevant to others on the listserve, I thought I would post what I found out here.From the American Psychiatric Association: http://pn.psychiatryonline.org/cgi/content/full/43/20/16Q. I have never enrolled as a Medicare provider and would like to opt out of the program. When I contacted my Medicare carrier, I was told I had to enroll before I opted out. Is this true?A. No. The Medicare carrier (or contractor) does need to be able to identify you, however, so you must provide your NPI, as well as your address, tax identification number, and medical license number. If you use the opt-out affidavit posted on APA's Web site, you will provide the carrier with all the necessary information. The affidavit can be accessed at the bottom of this Web page: <www.psych.org/MainMenu/PsychiatricPractice/MedicareMedicaid/OptingOutofMedicare.aspx>. -----------------------------This is from AAFP's web site:http://www.aafp.org/online/en/home/practicemgt/mcareoptions.htmlThere are basically three Medicare contractual options for physicians. Physicians may sign a participating (PAR) agreement and accept Medicare's allowed charge as payment in full for all of their Medicare patients. They may elect to be a non-PAR physician, which permits them to make assignment decisions on a case-by-case basis and to bill patients for more than the Medicare allowance for unassigned claims. Or they may become a private contracting physician, agreeing to bill patients directly and forego any payments from Medicare to their patients or themselves.Based on the above, my interpretation (which may not be correct) is that you have to choose one of these three options. If you have never enrolled in Medicare and you do not enroll as a partipating provider and you do not formally opt out of Medicare, then you are automatically choosing the 3rd option and you are a non-participating provider and subject to the rules associated with that status, including limits on how much you may charge a patient. SetoSouth Pasadena, CA

[Guest guest]

I agree – how cool that you are

having these gatherings, .

I discovered I was originally enrolled in

Medicare when I was in residency, but I was not aware of that until later, so

it can be a fairly stealthy occurrence, unfortunately.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

www.PinnacleFamilyMedicine.com

From:

[mailto: ] On

Behalf Of Seto

Sent: Sunday, November 02, 2008

3:10 PM

To:

Subject:

Question about Medicare opt out/non-par

Over the weekend, we had a little FP get together in the Pasadena area where IMPs,

pre-IMPs and non-IMPS just chatted at an informal gathering at my house. I

think it's good for the specialty and primary care in general to know our local

colleagues, plus it helps spread the IMP message. Anyways, one of the questions

that came up was: What do you do if you have never enrolled as a provider with

Medicare? Are you a non-participating doctor or are you considered opted out?

Do you have to enroll with Medicare just so you can opt out? Since this

question may be relevant to others on the listserve, I thought I would

post what I found out here.

From the American Psychiatric Association: http://pn.psychiatryonline.org/cgi/content/full/43/20/16

Q. I have never enrolled as a

Medicare provider and would like to opt out of the program. When I

contacted my Medicare carrier, I was told I had to enroll before I opted

out. Is this true?

A. No. The Medicare carrier

(or contractor) does need to be able to identify you, however, so you must

provide your NPI, as well as your address, tax identification number, and

medical license number. If you use the opt-out affidavit posted on APA's Web

site, you will provide the carrier with all the necessary information. The

affidavit can be accessed at the bottom of this Web page: <www.psych.org/MainMenu/PsychiatricPractice/MedicareMedicaid/OptingOutofMedicare.aspx>.

-----------------------------

This is

from AAFP's web site:

http://www.aafp.org/online/en/home/practicemgt/mcareoptions.html

There

are basically three Medicare contractual options for physicians. Physicians may

sign a participating (PAR) agreement and accept Medicare's allowed charge as

payment in full for all of their Medicare patients. They may elect to be a

non-PAR physician, which permits them to make assignment decisions on a

case-by-case basis and to bill patients for more than the Medicare allowance

for unassigned claims. Or they may become a private contracting physician,

agreeing to bill patients directly and forego any payments from Medicare to

their patients or themselves.

Based on the above,

my interpretation (which may not be correct) is that you have to choose one of

these three options. If you have never enrolled in Medicare and you do not

enroll as a partipating provider and you do not formally opt out of Medicare,

then you are automatically choosing the 3rd option and you are a

non-participating provider and subject to the rules associated with that

status, including limits on how much you may charge a patient.

Seto

South Pasadena,

CA

[Guest guest]

I agree – how cool that you are

having these gatherings, .

I discovered I was originally enrolled in

Medicare when I was in residency, but I was not aware of that until later, so

it can be a fairly stealthy occurrence, unfortunately.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

www.PinnacleFamilyMedicine.com

From:

[mailto: ] On

Behalf Of Seto

Sent: Sunday, November 02, 2008

3:10 PM

To:

Subject:

Question about Medicare opt out/non-par

Over the weekend, we had a little FP get together in the Pasadena area where IMPs,

pre-IMPs and non-IMPS just chatted at an informal gathering at my house. I

think it's good for the specialty and primary care in general to know our local

colleagues, plus it helps spread the IMP message. Anyways, one of the questions

that came up was: What do you do if you have never enrolled as a provider with

Medicare? Are you a non-participating doctor or are you considered opted out?

Do you have to enroll with Medicare just so you can opt out? Since this

question may be relevant to others on the listserve, I thought I would

post what I found out here.

From the American Psychiatric Association: http://pn.psychiatryonline.org/cgi/content/full/43/20/16

Q. I have never enrolled as a

Medicare provider and would like to opt out of the program. When I

contacted my Medicare carrier, I was told I had to enroll before I opted

out. Is this true?

A. No. The Medicare carrier

(or contractor) does need to be able to identify you, however, so you must

provide your NPI, as well as your address, tax identification number, and

medical license number. If you use the opt-out affidavit posted on APA's Web

site, you will provide the carrier with all the necessary information. The

affidavit can be accessed at the bottom of this Web page: <www.psych.org/MainMenu/PsychiatricPractice/MedicareMedicaid/OptingOutofMedicare.aspx>.

-----------------------------

This is

from AAFP's web site:

http://www.aafp.org/online/en/home/practicemgt/mcareoptions.html

There

are basically three Medicare contractual options for physicians. Physicians may

sign a participating (PAR) agreement and accept Medicare's allowed charge as

payment in full for all of their Medicare patients. They may elect to be a

non-PAR physician, which permits them to make assignment decisions on a

case-by-case basis and to bill patients for more than the Medicare allowance

for unassigned claims. Or they may become a private contracting physician,

agreeing to bill patients directly and forego any payments from Medicare to

their patients or themselves.

Based on the above,

my interpretation (which may not be correct) is that you have to choose one of

these three options. If you have never enrolled in Medicare and you do not

enroll as a partipating provider and you do not formally opt out of Medicare,

then you are automatically choosing the 3rd option and you are a

non-participating provider and subject to the rules associated with that

status, including limits on how much you may charge a patient.

Seto

South Pasadena,

CA

[Guest guest]

1 GAry this is cool- how did you find all of them to net work with ?excelletn idea2 I have thought about the medicare thing It is fascinating to me that the law in this country gives this program so much power over us Becasue a patient has this program the doc is subject to rules Even if you are non par the rules about what y ou can charge are there that you must learn and follow

All of us were enrolled when we were residents. The only folk who would never have been enrolled would be a FMG who did not do residency in the US and there are probably few of these Thus medicare has its' hand in every docs' pocket in america We cannot get away from it AS much as patients love medicare and as much as it is supposed to be so effcient and a good program there are these parts of it that are very scary.

Over the weekend, we had a little FP get together in the Pasadena area where IMPs, pre-IMPs and non-IMPS just chatted at an informal gathering at my house. I think it's good for the specialty and primary care in general to know our local colleagues, plus it helps spread the IMP message. Anyways, one of the questions that came up was: What do you do if you have never enrolled as a provider with Medicare? Are you a non-participating doctor or are you considered opted out? Do you have to enroll with Medicare just so you can opt out? Since this question may be relevant to others on the listserve, I thought I would post what I found out here.

From the American Psychiatric Association: http://pn.psychiatryonline.org/cgi/content/full/43/20/16

Q. I have never enrolled as a Medicare provider and would like to opt out of the program. When I contacted my Medicare carrier, I was told I had to enroll before I opted out. Is this true?

A. No. The Medicare carrier (or contractor) does need to be able to identify you, however, so you must provide your NPI, as well as your address, tax identification number, and medical license number. If you use the opt-out affidavit posted on APA's Web site, you will provide the carrier with all the necessary information. The affidavit can be accessed at the bottom of this Web page: <www.psych.org/MainMenu/PsychiatricPractice/MedicareMedicaid/OptingOutofMedicare.aspx>.

-----------------------------This is from AAFP's web site:http://www.aafp.org/online/en/home/practicemgt/mcareoptions.html

There are basically three Medicare contractual options for physicians. Physicians may sign a participating (PAR) agreement and accept Medicare's allowed charge as payment in full for all of their Medicare patients. They may elect to be a non-PAR physician, which permits them to make assignment decisions on a case-by-case basis and to bill patients for more than the Medicare allowance for unassigned claims. Or they may become a private contracting physician, agreeing to bill patients directly and forego any payments from Medicare to their patients or themselves.

Based on the above, my interpretation (which may not be correct) is that you have to choose one of these three options. If you have never enrolled in Medicare and you do not enroll as a partipating provider and you do not formally opt out of Medicare, then you are automatically choosing the 3rd option and you are a non-participating provider and subject to the rules associated with that status, including limits on how much you may charge a patient.

SetoSouth Pasadena, CA

-- If you are a patient please allow up to 12 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD

ph fax

[Guest guest]

Yes Thank you for all that you do. I was one of the " networker " . The get together was very successful. Maybe we can do this twice annually. I can host the next one. Also I am the one in Medicare limbo. never applied to Medicare, didn't do my residency in USA and my opt out letter got rejected. But I may have been enrolled by the HMO I worked for. I has sent a letter to medicare asking can a doctor be in Medicare as an individual and opt out as a group. On the phone, they did not know. When and if I ever hear back, I will post the answer.

Over the weekend, we had a little FP get together in the Pasadena area where IMPs, pre-IMPs and non-IMPS just chatted at an informal gathering at my house. I think it's good for the specialty and primary care in general to know our local colleagues, plus it helps spread the IMP message. Anyways, one of the questions that came up was: What do you do if you have never enrolled as a provider with Medicare? Are you a non-participating doctor or are you considered opted out? Do you have to enroll with Medicare just so you can opt out? Since this question may be relevant to others on the listserve, I thought I would post what I found out here.

From the American Psychiatric Association: http://pn.psychiatryonline.org/cgi/content/full/43/20/16

Q. I have never enrolled as a Medicare provider and would like to opt out of the program. When I contacted my Medicare carrier, I was told I had to enroll before I opted out. Is this true?

A. No. The Medicare carrier (or contractor) does need to be able to identify you, however, so you must provide your NPI, as well as your address, tax identification number, and medical license number. If you use the opt-out affidavit posted on APA's Web site, you will provide the carrier with all the necessary information. The affidavit can be accessed at the bottom of this Web page: <www.psych.org/MainMenu/PsychiatricPractice/MedicareMedicaid/OptingOutofMedicare.aspx>.

-----------------------------

This is from AAFP's web site:

http://www.aafp.org/online/en/home/practicemgt/mcareoptions.html

There are basically three Medicare contractual options for physicians. Physicians may sign a participating (PAR) agreement and accept Medicare's allowed charge as payment in full for all of their Medicare patients. They may elect to be a non-PAR physician, which permits them to make assignment decisions on a case-by-case basis and to bill patients for more than the Medicare allowance for unassigned claims. Or they may become a private contracting physician, agreeing to bill patients directly and forego any payments from Medicare to their patients or themselves.

Based on the above, my interpretation (which may not be correct) is that you have to choose one of these three options. If you have never enrolled in Medicare and you do not enroll as a partipating provider and you do not formally opt out of Medicare, then you are automatically choosing the 3rd option and you are a non-participating provider and subject to the rules associated with that status, including limits on how much you may charge a patient.

Seto

South Pasadena, CA

-- M.D.www.elainemd.com

Office: Go in the directions of your dreams and live the life you've imagined.

[Guest guest]

Amazing you got rejected in your attempt to opt out. That's like

trying to quit your job but your boss won't let you. " You can't leave

until I fire you! " . How lame...Is this still America?

>

> > Over the weekend, we had a little FP get together in the

Pasadena area

> > where IMPs, pre-IMPs and non-IMPS just chatted at an informal

gathering at

> > my house. I think it's good for the specialty and primary care in

general to

> > know our local colleagues, plus it helps spread the IMP message.

Anyways,

> > one of the questions that came up was: What do you do if you have

never

> > enrolled as a provider with Medicare? Are you a non-participating

doctor or

> > are you considered opted out? Do you have to enroll with Medicare

just so

> > you can opt out? Since this question may be relevant to others on

the

> > listserve, I thought I would post what I found out here.

> >

> > From the American Psychiatric Association:

> > http://pn.psychiatryonline.org/cgi/content/full/43/20/16

> >

> > Q. I have never enrolled as a Medicare provider and would like

to opt out

> > of the program. When I contacted my Medicare carrier, I was told

I had to

> > enroll before I opted out. Is this true?

> >

> > A. No. The Medicare carrier (or contractor) does need to be able

to

> > identify you, however, so you must provide your NPI, as well as

your

> > address, tax identification number, and medical license number.

If you use

> > the opt-out affidavit posted on APA's Web site, you will provide

the carrier

> > with all the necessary information. The affidavit can be accessed

at the

> > bottom of this Web page: <

> >

www.psych.org/MainMenu/PsychiatricPractice/MedicareMedicaid/OptingOuto

fMedicare.aspx

> > >.

> >

> > -----------------------------

> >

> > This is from AAFP's web site:

> >

> > http://www.aafp.org/online/en/home/practicemgt/mcareoptions.html

> >

> > There are basically three Medicare contractual options for

physicians.

> > Physicians may sign a participating (PAR) agreement and accept

Medicare's

> > allowed charge as payment in full for all of their Medicare

patients. They

> > may elect to be a non-PAR physician, which permits them to make

assignment

> > decisions on a case-by-case basis and to bill patients for more

than the

> > Medicare allowance for unassigned claims. Or they may become a

private

> > contracting physician, agreeing to bill patients directly and

forego any

> > payments from Medicare to their patients or themselves.

> >

> > Based on the above, my interpretation (which may not be correct)

is that

> > you have to choose one of these three options. If you have never

enrolled in

> > Medicare and you do not enroll as a partipating provider and you

do not

> > formally opt out of Medicare, then you are automatically choosing

the 3rd

> > option and you are a non-participating provider and subject to

the rules

> > associated with that status, including limits on how much you may

charge a

> > patient.

> >

> > Seto

> > South Pasadena, CA

> >

> >

> >

>

>

>

> --

> M.D.

> www.elainemd.com

> Office:

> Go in the directions of your dreams and live the life you've

imagined.

>

[Guest guest]

Well medicare actually called me today! They left a message- so one can be either opted in , non par or opted out. There is no duo status except in case of emergency. Are there forms one must file to be opted in or be non par? you would think they would have this on a web site somewhere,

Amazing you got rejected in your attempt to opt out. That's like trying to quit your job but your boss won't let you. " You can't leave until I fire you! " . How lame...Is this still America?

> > > Over the weekend, we had a little FP get together in the Pasadena area> > where IMPs, pre-IMPs and non-IMPS just chatted at an informal

gathering at> > my house. I think it's good for the specialty and primary care in general to> > know our local colleagues, plus it helps spread the IMP message. Anyways,> > one of the questions that came up was: What do you do if you have

never> > enrolled as a provider with Medicare? Are you a non-participating doctor or> > are you considered opted out? Do you have to enroll with Medicare just so> > you can opt out? Since this question may be relevant to others on

the> > listserve, I thought I would post what I found out here.> >> > From the American Psychiatric Association:> > http://pn.psychiatryonline.org/cgi/content/full/43/20/16

> >> > Q. I have never enrolled as a Medicare provider and would like to opt out> > of the program. When I contacted my Medicare carrier, I was told I had to> > enroll before I opted out. Is this true?

> >> > A. No. The Medicare carrier (or contractor) does need to be able to> > identify you, however, so you must provide your NPI, as well as your> > address, tax identification number, and medical license number.

If you use> > the opt-out affidavit posted on APA's Web site, you will provide the carrier> > with all the necessary information. The affidavit can be accessed at the> > bottom of this Web page: <

> > www.psych.org/MainMenu/PsychiatricPractice/MedicareMedicaid/OptingOutofMedicare.aspx> > >.

> >> > -----------------------------> >> > This is from AAFP's web site:> >> > http://www.aafp.org/online/en/home/practicemgt/mcareoptions.html

> >> > There are basically three Medicare contractual options for physicians.> > Physicians may sign a participating (PAR) agreement and accept Medicare's> > allowed charge as payment in full for all of their Medicare

patients. They> > may elect to be a non-PAR physician, which permits them to make assignment> > decisions on a case-by-case basis and to bill patients for more than the> > Medicare allowance for unassigned claims. Or they may become a

private> > contracting physician, agreeing to bill patients directly and forego any> > payments from Medicare to their patients or themselves.> >> > Based on the above, my interpretation (which may not be correct)

is that> > you have to choose one of these three options. If you have never enrolled in> > Medicare and you do not enroll as a partipating provider and you do not> > formally opt out of Medicare, then you are automatically choosing

the 3rd> > option and you are a non-participating provider and subject to the rules> > associated with that status, including limits on how much you may charge a> > patient.> >

> > Seto> > South Pasadena, CA> >> > > >> > >

> -- > M.D.> www.elainemd.com> Office: > Go in the directions of your dreams and live the life you've

imagined.>

-- M.D.www.elainemd.com

Office: Go in the directions of your dreams and live the life you've imagined.