How to Become a Medicare Provider

A federally funded health-care program, Medicare provides affordable health-care services to qualified U.S. residents. In addition to meeting certain requirements, Medicare recipients must also visit an approved physician or medical facility. These health-care providers in turn receive reimbursement for the services they provide. Although physicians must complete a lengthy application to become a Medicare provider, the process is relatively simple once you have the required documentation.

Things You'll Need

• Contact Information for a Carrier in Your Area
• National Provider Identification (NPI) Number
• Application
• Drug-Enforcement Administration (DEA) Certificate
• IRS Form W-9
• Medicare Provider Letter
• State Business License

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Instructions

How to Become a Medicare Provider

• 1

  Review the Medicare guidelines. In addition to the federal regulations, each state also has its own regional policies. You should be aware of both.

• 2

  Learn the differences between the types of Medicare policies. Generally, if you work in a nursing home or hospital, you'll need Part A Medicare, while private doctors and group practices will most likely require Part B Medicare.

• 3

  Obtain an NPI number. A requirement for any Medicare provider, this 10-digit number ensures Health Insurance Portability and Accountability (HIPAA) compliance.

• 4

  Contact the Medicare carrier in your area for a Medicare-provider application. As the point of contact for all Medicare issues, your carrier is also useful if you have any questions or concerns about the enrollment process.

• 5

  Complete the application in its entirety. You'll also need to include a copy of your drug-enforcement administration (DEA) certificate, IRS form W-9, Medicare provider letter and a copy of your state business license.

• 6

  Review the terms of your Medicare certification. Before you become a provider, you must agree to a non-discrimination standard, maintain a valid business license and comply with all of the program's reimbursement terms.

• 7

  Mail copies of all your forms to your local Medicare carrier. It can take up to seven weeks to process your application.