Participating Medicare Providers in California versus Non-Participating Providers

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If you are a patient and wanted to know the difference between  

Participating Medicare Providers in San Francisco, California versus Non-Participating Providers, then you are looking at the right article. It is kind of vague when you hear the word “participating,” and it can be misleading sometimes. But one thing is for sure is that both of them are involved in the Medicare program. The only difference between the two is the method of how these providers receive the payment and the amount. Below is some more information on both providers:

Participating Providers- they are providers and suppliers that agreed with Medicare to take assignments or to provide all covered services for all Medicare Part B beneficiaries on an assigned basis. 

Non-Participating Providers – they are providers and suppliers that don’t sign an agreement with Medicare. It is also their discretion whether or not they want to accept assignments.

Wondering What Types of Services A Participating Medicare Provider in California Can Provide?

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Patient’s will often ask, ” what types of treatments can a participating Medicare Provider render?” Below is a list of services / treatments that we feel you should be aware of:

1. Annual Wellness Visit

This service is an annual appointment with your provider in which your provider will create a personalized prevention plan concerning your health. This plan is helpful for patients because it covers a prevention plan against illnesses and to strengthen your immunity.

2. Preventive Services

Preventive services cover screening tests, preventive vaccines, and also counseling. Most of the services are covered by Medicare Part B.

3. Remote Patient Monitoring

 This type of monitoring uses digital technologies in collecting medical data from patients and transmitting the information to health care providers from a different location for an assessment. This way providers can continue to track the patient’s medical data once they are released to a care facility, hence, reducing readmission rates.  

4. Chronic Care Management 

Chronic care management helps patients in managing chronic conditions such as the following: 

  • arthritis
  • asthma
  • diabetes
  • hypertension
  • heart disease
  • osteoporosis
  • also mental health and other conditions. 

Patients may pay a monthly fee, and Medicare Part B deductible and coinsurance will also apply. This is a comprehensive care plan that lists all the information about the patient’s health. This way, the health care provider would know what type of care a patient needs. 

5.Virtual Check-ins

As the COVID 19 outbreak continues to spread, Virtual check-ins allow patients to talk to their doctors, nurse practitioners, or physician assistants, only by just using a device like phones, video calls, or captured video images without going to the doctor’s office.

These are some of the list of services patients should be aware of and take advantage as well. Also, see where most practices are by going to:

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