Participating vs Non-Participating
What does it mean when a provide states they are “participating” with Medicare? How does this differ from a ‘’non-participating” provider?
When enrolling with Medicare, if you agree to accept assignment on claims you are considered “participating.” Accepting assignment means you will submit claims for covered services provided to patients directly to Medicare.
You also agree to collect the patient’s deductible, co-insurance, or copayment plus reimbursement amount from Medicare as payment in full. In other words, you will not bill the patient for the difference in the amount billed to Medicare and the amount received.
If you choose to not accept assignment for Medicare beneficiaries, you are considered ‘non-participating” When you submit a claim for service to a Medicare patient, the payment will be sent directly to the patient.
For more information about Participating vs Non-Participating, contact the National Supplier Clearinghouse at NSC - palmettogba.com