Simply put, the primary difference between the two statuses
lies in how you collect your fees. Participating providers must accept
assignment (wait for payment directly from Medicare), while non-participating
providers may collect up-front from the patient (non-assigned claims). That is,
if you are a participating provider, your patient pays you a deductible and
co-insurance and then Medicare reimburses you for the rest of the allowed
fee. Non-participating providers may collect their allowed fees in full from
the patient and the beneficiary is then, in turn, partially reimbursed by
Medicare. For non-covered services (anything that is NOT spinal manipulation),
all providers, regardless of status, may collect up-front from the patient.
Feb 4th, 2015
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