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We were all OPTED IN

1 Mar 2024 12:33 PM | Melissa Wilson (Administrator)

Aloha fellow clinicians.  As of January 1, 2024 we were all opted into Medicare (unless you have opted out).  I had read that if we want in we must apply and if we want out we must opt out.  I like most of you probably said, cool I'm just going to do nothing.  Well that nothing turned into me opted-in. I just got off the phone with United Health Care trying to figure out why I was getting paid $37.50 less for the same client with the same CPT code as last year.  Turns out we were opted into Medicare and we need to opt out.  Of course they did not make it easy, so I'm going to make this as easy as possible for you guys.  I'm not recommending to OPT-OUT as a HIAMFT board member, so please don't take this as a HIAMFT position, just want to share information with you all.  I also want to note I am not a professional 'opt-outter'... so if you know something that I missed feel free to email me at melissa@kauaithera.com and I will update this blog.

Step 1: Go to this website, it will give you the overview of the process

https://med.noridianmedicare.com/web/jeb/enrollment/opt-out

Step 2: Print out 'Medicare Opt-out Affidavit", fill out and sign.  The Date you sign is your Opt-out date.  I am dating mine 1/1/2024.  The date you sign must also be within  120 days of the date you are requesting to be opted out.

Here is the form:

https://documentationwizard.com/how-to-opt-out-of-medicare-and-still-get-paid/

Step 3: Hawaii is in Jurisdiction E of Medicare, you can mail or fax this document.  It was recommended to include a copy of your license.  Although a fax number is listed, I would mail this in, maybe even certified mail.

Fax (701)277-7868

Mail

Noridian JE Part B

Attn: OPT OUT Medicare

4510 13th Ave S

Fargo, ND 58103

Step 4:  When you have a client that has medicare you must give them this form.  If you get audited by Medicare you will need to provide this form.

https://www.ngsmedicare.com/documents/20124/121641/529_0309_Medicare%2BPrivate%2BContract%2BForm_FF.pdf/6978c8fe-bc14-0e59-492f-dbcf3a3a3245?t=1611698980243.  

This will automatically renew every two years and you will be notified if you want to opt back in in two years

I'm not sure what will happen to our clients who are medicare/medicaid.  According to one site, if I opt out of  medicare, I will not get paid by medicaid.  I will update when I get an RTP in the mail as I have a few of these clients.

Lastly here is another website I found with some helpful info

https://documentationwizard.com/how-to-opt-out-of-medicare-and-still-get-paid/

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