The non-participating provider may receive reimbursement for rendered services directly from their Medicare patients. They submit a bill to Medicare so the beneficiary may be reimbursed for the portion of the charges for which Medicare is responsible.
Medicare billing for non-participating Providers
A non-participating Provider is a Provider involved in the Medicare program who has enrolled to be a Medicare Provider but chooses to receive payment in a different method and amount than Medicare Providers classified as participating.
ChiroFusion Support
Updated Sep 12, 2024
Was this article helpful?
Your feedback helps us continuously improve our documentation.
Related Articles
Medicare AT, GA, GX, GY, and GZ modifier requirements for chiropractic billing
Medicare coverage of chiropractic services may require the use of specific modifier codes.
How do I ensure that an insurance payment is sent directly to me and not the patient?
This article covers the specific settings required for Assignment of Benefits to ensure that insurance payments are issued directly to the Provider or Facility (as opposed to the patient).
How do I convert an insured patient to self-pay?
This article covers the steps required to convert and insured patient to self-pay.
Medicare specific requirements for the HCFA 1500 claim form
Medicare has specific requirements for how they want claims submitted on the HCFA 1500 Claims forms. Below we have outlined the areas where you can enter the necessary information to satisfy these Medicare specific requirements.
