Must I Enroll in TRICARE to Treat TRICARE Patients

As more and more practices choose not to enroll with commercial insurance carriers, including Medicare Advantage programs, a common question I am asked is must I enroll with TRICARE to be able to provide outpatient therapy services to TRICARE beneficiaries. In this article, I will provide the answers (with resources) to some of the more common questions I receive. QuestionMust I enroll with TRICARE to be able to provide outpatient therapy services to TRICARE beneficiaries? Answer QuestionWhat does TRICARE mean when they state “any TRICARE-authorized provider who hasn’t joined the network is a non-network provider? Answer QuestionCan a physical therapist … Read More

Medicare Advantage and OON Questions and Answers

Lately, I have been receiving questions from providers who are not contracted with Medicare Advantage plans and who want to know if they can evaluate and treat those patients and charge them cash. In this article, I will answer the following questions: I’m enrolled in the Medicare program as a participating provider and not enrolled with the Medicare Advantage (MA) plan. The MA plan does have out-of-network (OON) benefits. Must I submit a claim to the MA carrier and are there limitations in how much I can charge the patient? I’m enrolled in the Medicare program as a non-participating provider … Read More