At 1ˢᵗ Credentialing we know that when our clients place their trust in us, we take that responsibility seriously by communicating with our clients to create a transparent and collaborative partnership.
Healthcare organizations of every size realize that hiring 1ˢᵗ Credentialing is the most economical and efficient way to solve their credentialing needs. We have the training, expertise and commitment it takes to keep a complex process moving forward at all times.
1ˢᵗ Credentialing supports healthcare practices of all sizes - from health systems, to community hospitals, to large group practices, to smaller organizations. We help get your providers up and practicing as fast as possible.
Learning more about the credentialing process benefits us and our clients. 1ˢᵗ Credentialing offers regular videos and newsletter updates to bring our clients and those interested in innovations in credentialing up to speed.
CMS Reports Fewer Doctors Opt Out of Medicare Participation in 2017
The Centers for Medicare & Medicaid Services (CMS) is reporting a sharp decrease in the number of doctors and other medical clinicians opting out of Medicare participation in 2017.
At this point, it is unknown why the numbers went down last year. It may be because under the Medicare Access and CHIP Reauthorization Act (MACRA), providers no longer have to submit an Opt Out Affidavit every 2 years. Instead, once doctors have opted out of Medicare participation, they stay out indefinitely until they decide to rejoin the program.
Altogether, 3,732 providers dropped out in 2017. This is almost a 50% reduction compared to the prior year when 7,400 dropped out in 2016, but is on par with the 2015 rate of 3,500.
Opting Out of Medicare
The “Opt Out” process is a contract between a provider and Medicare, as well as separate contracts between a provider and beneficiaries. The contracts specify that the provider or beneficiary does not file a claim to Medicare for services rendered. In this case, the health care provider bills the beneficiary directly. Neither party is reimbursed by Medicare.
The provider does not have to follow the fee-for-service charges established by Medicare.
A private contract is signed between the health care provider and the beneficiary, stating that neither one can receive payment from Medicare for services. More information is available at this MLN Matters publication.
The Opt Out process requires that providers submit an affidavit to that effect with Medicare.
In essence, the 2017 change specifies that the former Opt Out 2-year periods are automatically renewed without any action required by the provider.
Let Us Manage All Your Payer Enrollment Services
If you require medical credentialing and payer enrollment needs for your practice or medical facility, please contact 1st Assistant. Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly and will monitor your account for ongoing updates and re-attestations. Heidi Henderson, our company owner and President, is eager to meet you and discuss your payer enrollment needs. Please call us at 512.201.2668 or contact us via the website.
Our credentialing experts are here to help you assess exactly which solutions you need and let you know how inexpensively we could put you on the right track. 1ˢᵗ Credentialing includes primary source verification and payor enrollment for all insurance networks including Medicare, Medicaid, Medi-Cal and insurance networks. Don’t wait another minute, contact our terrific team today!