FAQs of Opting Out of Medicare

Opting out of Medicare has caused a lot of confusion for NPs and other providers. Not understanding what it means can lead to problems & fines.

In this episode of the NP Business Matters Podcast (Episode #65) I address:

• The Social Security Act and how that impacts providers.
• When you can bill Medicare and when you don’t have to.
• What it means by opting out of Medicare.
• Can you just refuse to see Medicare recipients?
• Can I just have them sign something that says they understand I don’t bill Medicare?
• I’ve never had a Medicare provider number, can I just not credential with them?

Topic Resources

• Social Security Act Section 1848
• Medicare Claims Process Manual -CMS Mandatory Claim Submission Requirements and requirements for billing
• Mandatory Claim Submission (Noridian)
• Medicare, are you in or out?
• Opting Out of Medicare

More Resources

• Catch up on all the NP Business Matters podcasts here.
• Check out the Nurse Practitioners in Business Facebook Group
• Become a Member of the NPBO™
• Ready to start your own practice?
• Looking for more ways to increase your revenue, especially with Medicare? Don Self is the undisputed expert on medical reimbursement. And he has offered anyone associated with NPBO a 10% discount on anything purchased in his store, as long as you use the coupon code “NPBO” when you check out. https/donself.com

Connect with the Podcast

You can find the NP Business Matters Podcast on popular podcasting platforms:

• Apple Podcast
• Stitcher
• Spotify
• Google Podcast
• iHeartRadio
• Amazon Music/Audible
• Pandora
• And others. You’ll also find us in your favorite podcast player.

And as always, please subscribe, leave a rating, and share with your colleagues.

If you have requests for topics and/or guests, you can leave us a comment below, or anonymously fill out this form.

Your Turn

I invite you to share your thoughts, ideas, and/or questions in the comments below.