Article Detail - JF Part A

Noridian has seen an increase in providers opting out of the Medicare program. A provider has options when applying to Medicare. The provider may enroll as a sole proprietor, a sole owner of a business, or a group member enrolling under an organization. Visit the Noridian Medicare Provider Enrollment website for more information on enrolling as a provider under, Enroll in Medicare.

The enrollment option to order and refer is available when the provider may not bill the Medicare system.

OPT OUT:

• Two-year contract between provider, beneficiary, and Medicare where no claim is filed to Medicare
  • Beneficiary billed and paid provider direct, with fee-for-service charges not followed
• No requirement to opt out of Medicare, but if you do:
  • Affidavit must be filed with ALL Medicare contractors in provider’s jurisdiction
  • Keep private contract with beneficiary on file for two-year period
• Auto-renew unless updated affidavit resubmitted to reinstate approved Medicare provider
  • To cancel automatic renewal extension, you must notify the Medicare Administrative Contractor (MAC), or Noridian, in writing at least 30 days prior to the start of the next two-year opt-out period.
  • Visit the Noridian website for additional information on opting out of Medicare Opt Out of Medicare