You have three options:
- Sign a participation (PAR) agreement and accept Medicare's allowed charges as payment in full for all Medicare covered services for your Medicare patients.
- Elect nonparticipation (non-PAR), which allows you to make assignment decisions on a case-by-case basis and to bill patients up to the Medicare limiting charge for unassigned claims.
- Opt out and become a private contracting physician, agreeing to bill patients directly and forego any payments from Medicare to your patients or yourself. To become a private contractor, PAR physicians must give 30 days' notice before the first day of the quarter the contract takes effect. For non-PAR physicians, the opt-out effective date is the date the affidavit is signed, provided it is filed within 10 days after the physician signs his or her first private contract with a Medicare beneficiary.
Novitas Solutions, which replaced TrailBlazer Health Enterprises as the Medicare contractor for Texas on Nov. 19, has several resources on its website. They include an overview of Medicare assignment, participation, and the opt-out process. A separate page on the Novitas website offers more detailed information on the opt-out process. The page also includes a sample affidavit a physician must file if he or she decides to opt out.
Action, Dec. 17, 2012