Listen up, doctors, suppliers, and anyone billing Medicare for patient care! There’s a new wrinkle in the world of enrollment – the “stay of enrollment.” Don’t worry, it’s not a complete shutdown, but it is a yellow card from Medicare.
So, What Exactly is a Stay of Enrollment?
Think of it like a temporary hold on your Medicare enrollment. It’s a wake-up call from Medicare saying, “Hey, you haven’t been following the rules!” Unlike getting kicked out completely (which is called deactivation or revocation), a stay gives you a chance to fix things.
Who Can Get Hit with a Stay?
Anyone enrolled in Medicare as a provider can be on the receiving end of a stay notice. This includes physicians who forget to update their address after moving their practice, or suppliers who haven’t responded to requests for information. Basically, if you’re not playing by Medicare’s enrollment rules, you could be facing a stay.
Examples of Enrollment No-Nos:
Imagine you’re a doctor and you completely forget to tell Medicare about that snazzy new office location across town – that could land you in a stay situation. Or, maybe you’re a supplier who sells fancy knee braces, but you haven’t gotten back to Medicare about some paperwork – same story, buddy.
What Happens During a Stay?
Hold on to your stethoscopes, doctors, because here’s the not-so-fun part: while you’re stuck in this stay zone, you can’t bill Medicare for any services you provide. It’s like a pause button on your income stream. The good news? Stays typically only last 60 days, or less if you fix the problem faster.
How to Get Out of Stay Jail
The key to escaping stay jail is simple: fix the problem Medicare flagged. Did you forget some paperwork? Get it in! Did you miss a deadline? Catch up! Once you’ve addressed the issue, contact Medicare to show them you’re back on track and ready to bill again.
The Bottom Line for Patients
Patients, this might affect you indirectly. If your doctor gets hit with a stay, claims for services received during that time might be denied. This could mean a delay in getting care or having to find a different provider while your doc sorts things out with Medicare.
Stay Informed, Stay Compliant!
The best way to avoid a stay of enrollment is to stay informed about the rules and keep your Medicare information up-to-date. Talk to your Medicare Administrative Contractor (MAC) or check out the Medicare Program Integrity Manual for all the details. Remember, a little vigilance goes a long way in keeping your Medicare enrollment smooth sailing!
For more information please see:
https://www.cms.gov/files/document/mm13449-stay-enrollment.pdf
