Medicare enrollment

Has anyone successfully completed Medicare enrollment as an independent RN providing patient advocacy/care coordination. If so did you need a supervising physician?

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AnnMarie AnnMarie Cross 17 days ago
Hi, Rachel!
Do you mean you are trying to become an advocate who accepts Medicare?

if so, there are a number of agencies around the country that accept Medicare. It is my understanding that an RN must work under a licensed supervising clinician, and the setup is long, indepth and complex. I know of one RN advocate who is deep into the process and actually building a training program she intends to offer once she has reached sort of 'a good endpoint' with the process.

I hope other nurses might respond here to provide more information, although if this question is about accepting Medicare as reimbursement, it's likely in the wrong conversation space, and I can move it for you.

If you would like the list of agencies that we at GNA are aware of and have had at least some contact with/knowledge of, feel free to ask. I'll gladly share it here.
Rachel Rachel Yates 17 days ago
Thank you I am in the process of having a licensed supervising clinician and realizing it is a difficult process to set up. I am just looking for some guidance so I'm not making any mistakes and have to extend the already long process
Martine Martine Brousse 17 days ago
a physician will bill for your services after they and you meet certain requirements. You must be an employee or independent contractor for this physician. You cannot bill Medicare directly
Rachel Rachel Yates 17 days ago
Ok great I'm doing the independent contractor for my physician model. I just wanted to make sure that was doable. There is not much information on it
Rachel Rachel Yates 17 days ago
Not sure if you know but if I am going the independent contractor route I wouldn't have to fill out a PECOS application then since the provider would already have this? Am I understanding that right?
AnnMarie AnnMarie Cross 16 days ago
Yes, it's a VERY complex process that there are a few advocates who are trying to navigate on their own.

Remember — your supervising physician/agency must be in network with their medigap or medicare advantage plan to be able to accept payment from those plans. That's the biggest hurdle that is one that many of the agencies going down this path are really struggling to complete. (There are roughly 6,000 separate Medicare Advantage plans, through dozens of insurers.)

One advocate — who is I would say about 18 months into the process so far — is developing a training program other advocates will be able to purchase and work through, but I don't think she's got a timeline on that yet.

Most advocates wishing to accept Medicare at this stage are working through one of numerous agencies who have done all of the setup themselves.
AnnMarie AnnMarie Cross 16 days ago
If you or any of your readers would like the list of agencies that GNA knows of/has spoken with who are accepting Medicare and have advocates working as contractors with them, I'm happy to provide it.