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The Dark Side of Medicare Advantage Plans

Nurse Practitioners in Business

Recently an NPBO Member shared with me a report on Medicare Advantage plans and the increasing amount of prior authorizations that are being required with Advantage plans. This is true for Original Medicare and Medicare Advantage Plans. Medicare is a complex topic for consumers and providers alike.

Medicare 397
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FAQs of Opting Out of Medicare

Nurse Practitioners in Business

Opting out of Medicare has caused a lot of confusion for NPs and other providers. When you can bill Medicare and when you don’t have to. What it means by opting out of Medicare. What it means by opting out of Medicare. Can you just refuse to see Medicare recipients?

Medicare 221
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What you need to understand about Medicare cuts

Nurse Practitioners in Business

Hearing about Medicare cuts causes a provider’s blood to run cold. Will you really lose money by seeing Medicare patients? I am constantly asked “Should I opt out of Medicare?” In fact, at 66 years old, I am a beneficiary of Medicare Part B and a Medigap plan. And many have strong opinions on this.

Medicare 221
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Don’t Let Tax Season Sneak Up: Use This Checklist

Nurse Practitioners in Business

Ensure Payroll Tax Compliance: If you have employees, make sure payroll taxes (Social Security, Medicare, and unemployment taxes) are withheld and remitted. To sum up … By following this checklist, Nurse Practitioners in business can stay organized, file their taxes on time, and avoid penalties.

Business 286
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What Is A Clearing House & Do You Need One?

Nurse Practitioners in Business

However, it is strongly suggested that you do, considering Most larger insurance companies, and certainly Medicare and Medicaid, prefer and/or require electronic claims submission, which includes a clearinghouse for efficiency and accuracy. You’re only billing a single payer, such as Medicare, and they allow direct submission.

HIPAA 195
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Understanding Participating and Non-participating provider status for NPs

Nurse Practitioners in Business

On the surface, it sounds like having non-participating provider status with Medicare is a good thing. Medicare requires NPs enrolled with Medicare as a provider to accept assignment. Check out the Nurse Practitioners in Business Facebook Group Become a Member of the NPBO Ready to start your own practice?

Medicare 221
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Record-Keeping Beyond Charts

Nurse Practitioners in Business

Compliance Program Policies (even if youre a solo provider) A basic compliance program should include: Written policies and procedures A code of conduct A defined process for reporting and handling potential compliance issues CMS and OIG recommend this even for small practices, especially those billing Medicare or Medicaid.

HIPAA 195