Provider Application

Medicare Provider Application – Will your medical advisor need to apply as well?

The U.S. supplies a medical insurance policy called Medicare. Medicare only is applicable to citizens who have reached or passed the ripe old age of 65. You may still be able to apply your medical condition meets certain criteria.

The organisations behind Medicare are the Centers for Medicare and Medicaid Services department (CMS). If you want to get the maximum benefit from Medicare, You will first have to discuss the details with your current doctor; coverage will only be accepted if an application for Medicare is completed by both you and your physician.

Be warned, Medicare coverage can be changed without a moments notice. So always contact your Social Security Agency previous to applying.

Personal Coverage

When you reach the good old age of 65, you will more than likely be eligible for Medicare. You will be informed this a few months before you reach 65. If you are younger with a medical condition, contact your Social Security Agency as you may also qualify. If you are already benefiting from Social Security, you should automatically be signed up for parts A & B in the Medicare program. However, a premium must be paid if you require the coverage of Part B. This can be opted out of as it totally your choice.

You may find the enrolment process does not automatically select you. In this instance you will have to fill out a Medicare form CMS 4OB. You can get your hands on this form by either visiting your Social Security Administration office or call 1-800-772-1213 to make a Medicare application appointment.

To make things easier, a monthly benefits application for disability, retirement or a partner is submitted when applying for Medicare. You can apply online for Medicare’s monthly benefit at https://s044a90.ssa.gov/apps6z/ISBA/main.html Help can also be offered via your Social Security office.

Medical Providers Coverage

If you provide medical assistance, and wish to be included in this health insurance plan, you will need to present a Medicare form. An example is form CMS10115 section 10115 covering doctors, hospitals and ambulances. The following information would be required:

1.       General contact information

2.       Medicare ID number

3.       Federal Tax ID number

4.       List of doctors with hospital entitlements (Hospital only)

5.       Provider numbers (Hospital only)

Medicare Enrolment Application – Institutional Providers (Application CMS 855A)

Providers they effect in alphabetical:

·         Community Mental Health Centers

·         Comprehensive Outpatient

·         Critical Access Hospitals

·         End-Stage Renal Disease Centers

·         Government approved Health facilities

·         Rehabilitation Facilities

You can download CMS 855A is available for download at http://www.cms.hhs.gov/cmsforms/downloads/cms855a.pdf

Medicare Enrolment Application – Clinics/Group Practices and Certain Other Suppliers (Form CMS 855B)

Providers they effect in alphabetical:

·         Ambulance Service Providers

·         Ambulatory Surgical Centers

·         Clinic/Group Practices

·         Independent Clinical Laboratories

·         Other facilities stated on the form

Form CMS 855B is available to download at http://www.cms.hhs.gov/CMSforms/downloads/cms855b.pdf

There are further Medicare Applications which are able to be talked about or found on the website. If you are the patient or the physician, the enrolment process starts with a Medicare application

Entry Filed under: Enrollment Questions