Medicare Participation and Non-Participation

Enrollment vs. Participation Participation in the Medicare program has nothing to do with Medicare enrollment. All chiropractors that treat Medicare patients must be enrolled in the Medicare program. Enrollment requires the completion of the CMS Form 855—the “Medicare Enrollment Application (See Fig. 1).” An annual open enrollment period held the last few months of the...
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Medicare Collections Guidance

Medicare billing is very closely scrutinized so it’s important to get it right the first time. Remember, it’s not your decision whether to bill Medicare regardless of whether you’re participating or non-participating…that decision rests with the patient. This course walks you through the importance of using the right fee schedule, billing the right party, and...
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Charging Appropriately for Medicare Services

Charging Medicare Patients Correctly As with any patient, providers are responsible for charging patients correctly and then accurately billing them or billing on their behalf. Because a provider may be participating or nonparticipating with Medicare, and because only a few services are actually covered by Medicare, the process is not straightforward. Here are the most...
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FAQ-Medicare Fee Schedule

Medicare Fee Schedule FAQs Q: Where can I find my Medicare Fee Schedule? A: You can find the Medicare Fee Schedule on your Medicare Administrative Contractor’s (MACs) website. Many of the MACs offer a link on their home page that directs you to the fee schedule look-up tool. You need to know your enrollment status...
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Medicare ABN Templates

Medicare ABN Templates This module provides specific direction on proper Mandatory ABN usage. In order to ensure that your ABN forms are exactly as they should be, we’ve provided a number of master templates for various situations that you may encounter, so that you can customize your ABN forms for your practice. Review each carefully,...
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Par VS Non-Par Comparison

Differences Between Participating and Non-Participating Providers This image provides a snapshot of the difference between Participating Providers and Non-Participating Providers in the Medicare Part B program. This at-a-glance image demonstrates how the obligations are slightly different between the two options. Participation status is a highly personal decision for providers, but it should be noted that...
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