How to Become a Medicare Provider in California

Step-by-Step Guide

1. 1

   Step 1: Learn the types of Medicare.

   Any physician or non-physician medical care or supply provider who offers services or goods necessary for the physical and mental health of those who receive Medicare coverage are eligible to apply as providers.
   
   Depending on the type of goods or services you offer, the application process includes a number of steps to ensure eligibility.
   
   It’s important to review the various types Medicare coverage and how your clinic, practice, hospital, home health, or medical equipment provider fits into each part.
   
   Part A, or hospital Medicare, includes hospital treatments, long-term care facilities, home health, and hospice.
   
   Part B, or medical treatment Medicare, covers doctor services, preventive care, medical equipment, any outpatient procedures, lab testing, x-rays, clinical and outpatient mental health services, and other similar treatments.
   
   Part C is Medicare coverage offered by private insurance providers.
   
   Those eligible for Medicare can opt for the Part C plan and pay additional coverage fees, if they want to expand the services and providers included in their treatment plans.
   
   Part D covers prescription drugs.
2. 2

   Step 2: Complete additional paperwork for specialty care or suppliers.

   Durable Medical Equipment Prosthetics/Orthotics, and Supplies (DMEPOS) suppliers and Home Health and Hospice providers are required to provide extra information or apply through different agencies than the other Medicare coverage areas.
   
   Before submitting your application, make sure you don’t offer any of the services that may be included in these two areas.
   
   DMEPOS suppliers will need to complete additional criteria to be considered in compliance with the Clinical Laboratory Improvement Amendments (CLIA) in order to qualify to bill Medicare for the goods provided.Home Health and Hospice providers will need to complete additional forms and documentation for vehicles and other items.
   
   These will be added to the PECOS application, when you identify as a Home Health or Hospice provider.
   
   Additionally, Home Health and Hospice providers will receive Medicare provider approval through a different set of MACs than those that cover the other parts of Medicare., Medicare recognizes a variety of medical providers and suppliers as necessary to meet the health needs of its beneficiaries.
   
   Medicare relies on state licensing regulations to practice medicine to determine eligibility.
   
   In order to be approved as a Medicare provider or supplier, you will need to meet licensure regulations and legal authorizations to practice within the state of California, your county, city, and other local If you work as part of a clinic or hospital, your facility will need to be an approved Medicare provider prior to your application to accept Medicare individually.
   
   You will need to be licensed to practice medicine and meet all state and local medical certifications as an individual and organization.
3. 3

   Step 3: Establish your eligibility as a Medicare provider.

Detailed Guide

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