Updates for the Opting-Out Process

Effective December 24, 2019, the opt out process has been updated. Below are the highlights of what was updated. To review the updates in detail, check out the Opt Out of Medicare page on the Noridian Medicare website.

  • Additional Opt out Affidavit to other Medicare Administrative Contractors (MACs): Once a provider opts out of Medicare, they are opted out across the United States of America and territories. If the provider goes from one MAC to another, an additional opt out affidavit will need to be submitted to the new MAC.
  • Appeals: An opt out can now be appealed to the Centers for Medicare & Medicaid Services (CMS).
  • Emergency Services: In order to bill for Emergency Services, the provider will need to fully enroll. Once the claims have been submitted and paid, Noridian will work with CMS to place the provider back into an opt out status.
  • Renewal of Opt Out Status: A notification letter will be sent out roughly 90 days before the opt out is renewed for another 2 year period.
  • Order and Refer Services: If the provider wishes to order and refer services, this must be indicated on the affidavit.

 

Last Updated Jan 14, 2020