decisionhealth Newsletters, Part B News - 2008 Issue 1 (January)
Non-par a risky tactic for most practices, experts say
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Article Overview
This article discusses Medicare participation status for physician practices and reviews the financial and operational considerations associated with non-participating arrangements. It covers general reimbursement differences, patient collection issues, administrative burden, and the kinds of practices that may or may not be suited to this approach. The piece is written for practice administrators, physicians, and reimbursement professionals evaluating Medicare strategy.
Why This Topic Matters
Participation status can materially affect cash flow, collections, patient volume, and administrative workload. Understanding the tradeoffs helps practices assess whether a change in Medicare status aligns with their business model.
What You Will Learn
- How Medicare participation status affects practice reimbursement and patient billing responsibilities.
- Why collections can become more complex when claims are not assigned.
- What operational factors experts consider when evaluating whether a practice should remain participating or move to non-participating status.
- How practice type, market position, and patient expectations influence the viability of this strategy.
Who Should Read This
- Physicians
- Practice administrators
- Revenue cycle professionals
- Medical billing professionals
- Healthcare consultants
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