Guidance on Opting In or Out of Medicare

Members have asked for guidance in determining whether to opt in or out of Medicare. First, very few dental procedures are covered by Medicare.  This web site describes the covered dental services.
http://www.cms.gov/Medicare/Coverage/MedicareDentalCoverage/index.html

If you are providing these services, then you should already be enrolled as a Medicare provider and are submitting claims accordingly.  The rest of this narrative is for the vast majority of Indiana dentists who are not enrolled in Medicare.

This link has decision tree to aid in this process:
http://success.ada.org/en/practice/medicare/medicare/medicare-decision-infographic

The following link is a good question and answer page prepared by the ADA.  If you are unfamiliar with this opt in or out question, please read through this material now.
https://www.ada.org/en/member-center/member-benefits/legal-resources/publications-and-articles/reimbursement/medicare-enrollment-decision-tool-introduction-medicare-enrollment/medicare-enrollment-faq

If you serve Medicare or Medicare Advantage patients, the deadline is February 1, 2017 January 1, 2019 to either enroll as an Ordering and Referring Practitioner or to opt out. Please allow 90 days for your enrollment to be processed.

Opt In/Opt Out Forms

Medicare has contracted with Wisconsin Physician Services (WPS) to handle the enrollment of Indiana dentists for opting in and opting out of Medicare. To opt in, you must complete Form 885O. To opt out, you must complete the Medicare Opt Out Affidavit.

After completing the appropriate form, print, sign and mail to WPS:
Wisconsin Physicians Service
Medicare Provider Enrollment
P.O. Box 8248
Madison, WI 53708-8248

Overnight Delivery Mailing Address
Wisconsin Physicians Service
Medicare Provider Enrollment
1717 W. Broadway
Madison, WI 53713-1834

To see a listing of Indiana dentists who have currently opted out of Medicare, click on this link and see specialty fields #19 and #85.
http://www.wpsmedicare.com/j8macpartb/departments/enrollment/in-opt.shtml

If you have further questions, please contact Ed Rosenbaum at (800) 562-5646 or edr@indental.org.