Recently an NPBO Member shared with me a report on Medicare Advantage plans and the increasing amount of prior authorizations that are being required with Advantage plans. But that is just one disadvantage of these plans… If you, a family member, or a friend receive Medicare, you’re well aware of the uptick in marketing (aggressive Read More
On the surface, it sounds like having non-participating provider status with Medicare is a good thing. But for NPs, is it really? Medicare requires NPs enrolled with Medicare as a provider to accept assignment. That the rule had always taught me that NPs could not opt for “non-participating” provider status. Recently though, I’ve heard from Read More
Hearing about Medicare cuts causes a provider’s blood to run cold. Let’s look deeper – are they really cuts? Will you really lose money by seeing Medicare patients? I am constantly asked “Should I opt out of Medicare?” and/or “Should I start or switch to a cash-only practice?” by NPs who are new to business Read More
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 Read More
The idea of opting in or out of Medicare is a frequent question we receive. In this episode of the NP Business Matters Podcast, Short Takes, we discuss this in further detail. The most important thing clinicians need to understand is when you opt out of Medicare, you are out everywhere. It’s global. You are Read More
There is a good amount of confusion among nurse practitioners and others regarding Medicare reimbursement and Incident-to billing. In this question of the week, I address: What incident to is The rules for appropriate billing of incident to Why you don’t want to use it How it affects your reporting status for MIPS (MACRA) The Read More
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