Billing Medicare as an non-contracted provider

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I have a client I've been doing work for that has a patient with Medicare as Primary and BCBS as secondary insurance. The client is an LCSW. The problem is they are not contracted Medicare providers and have no desire to become so. I've done some research and spoken with an agent at Noridian. I was originallly told that I can still bill Medicare without being a contracted provider by registering as a non-contracted provider. However, after going through a long and painful credentialing process, discovered that LCSWs do not qualify to registered as non-contracted providers.

So my question is where do I go from here? I have billable charges that need to be collected on.

Can the patient submit the claim to Medicare themselves? And then will the claim automatically cross over to the secondary insurance or will I need to submit the primary information to the secondary myself?

I've never billed for a client that is not a Medicare provider.


True Blue
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Something sounds amiss here and I think you might have been given some incorrect information along the way. To start with, Medicare doesn't have 'contracted' or 'non-contracted' providers - Medicare doesn't enter into contracts with providers like commercial plans do. So I'm not sure what you mean when you say that LCSWs do not 'qualify' to register as non-contracted. Providers 'enroll' with Medicare, and an LCSW should be able to enroll - Clinical Social Worker is listed as an option on the 855I form and I've never heard of that type of provider being excluded. Once enrolled, provider can accept assignment or not accept it, which is a different thing from being non-contracted. Unless by being non-contracted you're meaning they wish to 'opt out' of Medicare which is an entirely different thing - could you clarify some?