Tuesday, May 5, 2015

MEDICARE PROVIDER SIGN-UP DEADLINE APPROACHING

June 1, 2015 is the deadline for dentists to opt-in or opt-out of being a Medicare provider.  Most dentists are well aware that Medicare does not cover standard dental services; and, therefore, question the necessity of signing up.  However, some dental services, surgeries for example, may be covered under Medicare or Medicare Advantage plans and some medicaments prescribed by a dentist, for example antibiotics for prophylactic coverage of patients with joint replacements or heart issues, may be covered as well.  Your Medicare-age patients will expect you to help them take advantage of any available benefits, and your office can do so only if you opt-in to be a provider.

Though it seems odd, knowledgeable advisers declare that healthcare providers must make a choice between being a Medicare provider or not, and file paperwork either way.  Opting-out of being a Medicare provider requires compliance with specific regulations, including maintenance of proper documentation and meeting deadlines.  The healthcare provider who chooses to opt-out will be locked out for two years, at which time he/she will again have to go through the opt-out or opt-in decision making process and all necessary paperwork.

Opting-in also requires proper completion of applications, documentation, and specific compliance requirements.  The dentist who opts-in agrees to submit patients’ eligible claims to Medicare and to accept Medicare limits on payment of fees.

The decision of whether or not to become a Medicare provider and the process of meeting compliance requirements is a tedious and time-consuming chore.  With the June 1 deadline looming, dentists should seek counsel from their own practice management consultant, their billing service, their state dental society, or the American Dental Association at www.ada.org.

 

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