How to Become Medicare Certified

Medicare is a federally funded health care program available to U.S. residents who meet certain qualifications. By reimbursing physicians' fees, the program provides affordable coverage for hospital stays, doctors' appointments and prescriptions. To receive these benefits, however, Medicare recipients must get health care from an approved clinic or physician. Providers, in turn, must apply to become Medicare certified to treat Medicare recipients.

Things You'll Need

• Medicare carrier's contact information
• National provider identification number
• Medicare provider application

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Instructions

How to Become Medicare Certified

• 1

  Determine the type of Medicare coverage you will provide. Nursing homes, hospitals, and home health care clinics will require Part A insurance, whereas private physicians and group practices will need Part B insurance.

• 2

  Apply for a National Provider Identification (NPI) number. This 10-digit number is required for any provider who wants to become Medicare certified, as it enables them to process standard HIPAA transactions.

• 3

  Locate a Medicare carrier in your area. In addition to the federal Medicare requirements, each state also has its own polices that providers should be aware of before applying for certification.

• 4

  Obtain a Medicare provider application. In addition to the completed form, you will also need to include a copy of your Drug Enforcement Administration certificate, state business license, IRS form W-9, Medicare provider letter and any other documents specific to your practice.

• 5

  Sign your application, staple all of the required documents together and mail the forms to your local Medicare carrier. Allow four to seven weeks for processing.

• 6

  Agree to the terms of your Medicare certification. These conditions include complying with the nondiscrimination standard, maintaining a valid medial license in your state and abiding by the program's reimbursement policies.