camilleb
Guru
Are there any non- par providers out there? I am now working for my first provider who is Medicare non-par. Does this mean you can bill a Medicare patient for a non-covered service? Thanks in advance!
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Medicare non-par - providers out there
- Thread starter camilleb
- Start date
RebeccaWoodward*
True Blue
Are you referring to statutorily non-covered items? If so, these are always billable to the patient.
Lisa Bledsoe
True Blue
We are non-par. You still have to follow CMS guidelines and unless it is denied as "patient responosibility" you cannot bill the patient. If it is a statutorily excluded service as Rebecca points out you can bill the patient whether you are par or non-par.
Jenny8675309
Networker
Don't forget the ABN. If you know it is going to be non-covered you will need an ABN signed by the recipient so they know it's non-covered and they are responsible.
Lisa Bledsoe
True Blue
ABN's are not required for statutorily non-covered services (ie preventive 99397). You can use modifier GY for these services.
Billing Medicare Non-Par
There are a couple of issues here. First do you have a PTN registered to you by PECOS. If you do not have a PTN you cannot bill Medicare. If you have a PTN you can choose to be Non-Par or Par. This can be an issue. My company does not have a PTN. We are currently going under accreditation and applying for a PTN. We are choosing to remain non-par. Having the PTN allows you to do business with the Federal Government. Depending on your circumstances, your office may choose to be non-par. There are benefits to this. It just depends.
There are a couple of issues here. First do you have a PTN registered to you by PECOS. If you do not have a PTN you cannot bill Medicare. If you have a PTN you can choose to be Non-Par or Par. This can be an issue. My company does not have a PTN. We are currently going under accreditation and applying for a PTN. We are choosing to remain non-par. Having the PTN allows you to do business with the Federal Government. Depending on your circumstances, your office may choose to be non-par. There are benefits to this. It just depends.