Friday, Apr 12, 2013

On May 1, Medicare will "turn on" a claim denial process that affects dentists and other health care providers ordering particular Medicare-covered items or services for Medicare beneficiaries.

As of that date, a provider of a covered clinical laboratory, imaging, durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) or home health service will not be paid if the ordering or certifying practitioner has not enrolled in Medicare or properly opted out.

The announcement of Phase 2 implementation in a special edition of Medicare Learning Network Matters includes guidance on orders or referrals by dentists.  For more coverage, please read the ADA News.