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This guide is a general summary that explains certain aspects of the Medicare Program, but is not a legal document.
CHAPTER ONE- INTRODUCTION TO THE MEDICARE PROGRAM 6
CENTERS FOR MEDICARE & MEDICAID SERVICES 7
THE MEDICARE PROGRAM 8
Part A and Part B Enrollment Periods 8
Part A – Hospital Insurance 9
Part B – Medical Insurance 12
Part C – Medicare Advantage 13
Part D – Prescription Drug Plan 14
ORGANIZATIONS THAT IMPACT THE MEDICARE PROGRAM 15
CHAPTER TWO - BECOMING A MEDICARE PROVIDER OR SUPPLIER 17
MEDICARE PROVIDERS AND SUPPLIERS 18
Part A Providers and Suppliers 18
Part B Providers and Suppliers 18
Physicians 19
Interns and Residents 19
Teaching Physicians 20
Practitioners 20
ENROLLING IN THE MEDICARE PROGRAM 20
National Provider Identifier 20
Medicare Enrollment Application 21
Participating and Nonparticipating Providers and Suppliers 23
PRIVATE CONTRACTS WITH MEDICARE BENEFICIARIES 26
PROMOTING CULTURAL COMPETENCY IN YOUR PRACTICE 27
CHAPTER THREE - MEDICARE REIMBURSEMENT 29
MEDICARE CLAIMS 30
Exceptions to Mandatory Filing 30
Electronic Claims 31
Electronic Media Claims Submissions
