Termination of Provider participation with Medicare

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After much thought and debate my physician has decided it is best for him to
terminate his participation status with Medicare.



I've read so many different things about how to "opt out" but don't want to
overlook anything.



Not sure if anyone has any sample forms for termination of participation
(affidavit), sample patient agreement contracts, or any other guidelines on
how much notice we need to give patients etc.



My local medical society suggest I not try to "terminate" on my own but have
a consultant do the paperwork for me because it can become a "paperwork
nightmare" if not done properly.



Any help / guidance is greatly appreciated.





Cheryl Sarnowski, Administrator

c/o Marc Irwin Sharfman, MD PA

2137 West State Road 434

Longwood, FL 32779-4983

Phone: 407-644-3737 x 114

FAX: 407-644-3009

Email: Cheryl@headache-institute.com





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x 114. Thank you.




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After much =
thought and debate my physician has decided it is best for him to =
terminate his participation status with Medicare.

 

I’ve =
read so many different things about how to “opt out” but =
don’t want to overlook anything.

 

Not sure if =
anyone has any sample forms for termination of participation =
(affidavit), sample patient agreement contracts, or any other guidelines =
on how much notice we need to give patients etc.

 

My local =
medical society suggest I not try to “terminate” on my own =
but have a consultant do the paperwork for me because it can become a =
“paperwork nightmare” if not done properly.

 

Any help / =
guidance is greatly appreciated.

 

 

Cheryl Sarnowski, =
Administrator

c/o Marc Irwin =
Sharfman, MD PA

2137 West State =
Road 434

Longwood, FL =
32779-4983

Phone: =
407-644-3737 x 114

FAX:  =
407-644-3009

Email: =
Cheryl@headache-institute.com

 

 

This =
electronic mail/email message and any attachments may contain =
confidential and/or private information intended solely for a specific =
individual and purpose and is protected by law.  If you are not the =
intended recipient of this email, you are hereby notified that any =
disclosure, copying, or distribution of this email and any attachments, =
or the taking of any action based thereon, is strictly prohibited.  =
If you have received this email in error, please notify the sender by =
reply email or call 407-644-3737 x 114.  Thank =
you.

 

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Comments

  • Cheryl,

    I will be happy to help you as we did this for two of our physicians back
    in 2014 and just renewed our Opt-Out contracts. Feel free to call me - I'm
    in Los Angeles (310) 553-4982 so we can discuss.

    Best,
    Penny Sue
    Administrator
    Century City Primary Care, LLC

    Penny Sue
    Administrator
    Century City Primary Care, LLC
    (310) 553-4982 office
    (310) 729-2758 cell

  • State law can also impact your decision. In Penna, we have the Medicare
    Overcharge Measure, or "MOM" law.
    A provider can be PAR, non-PAR, or "Opt-out" of Medicare.
    Once you opt out of Medicare, I think you need contracts with each Medicare
    beneficiary, and there are limits of charges, and restrictions on returning
    to Medicare.
    If you go to non-par status, there is the limiting charge to deal with.
    I suggest doing a lot of research and seeking counsel who is familiar with
    your state and the Medicare regs.
    Bob O.

  • Cheryl

    Considering that so few (101) of his patients were Medicare and he only billed 4 codes to Medicare Part B as a neurologist - it's probably a wise idea. If he were family practice, I would venture to say it would be foolish - but with his practice, I don't see it would hurt him to opt out.

    if you don't find someone on this listserv to help you, check with Sean Weiss and the folks at Doctors Management out of Knoxville, TN as they've helped alot of folks around the country in this endeavor.

    Don
    Don Self & Associates, Inc

    305 Senter Ave, Whitehouse, TX 75791
    903 871-1172 fax 480-247-5650
    donself@donself.com web: www.donself.com
    books & webinars at https://shop.donself.com

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