Add-Ons

Identifies health care providers disqualified from providing items or services to Medicare Advantage Plan members or prescription drugs to Medicare Part D beneficiaries. As of April 1, 2019 no Medicare payments may be made to any providers who are on the Preclusion List, and that Medicare Advantage Plans and Part D drug providers must have notified covered beneficiaries and be ready to begin denying claims.

If a healthcare practitioner chooses to opt out of Medicare, it means that he or she opts out for all covered items and services that he or she furnishes. Each Opt-Out contract lasts for a minimum two-year period beginning the date the practitioner files and signs an affidavit that he or she has opted out of Medicare. Participating Medicare providers can opt out at the beginning of each calendar quarter, and non-participating physicians can opt out at any time. If a provider “opts-out” of Medicare, they must contract privately with Medicare patients or beneficiaries to provide covered services. Individuals who are able to “opt out” of Medicare include doctors (medicine, osteopathy, optometry, pediatric medicine, dental surgery), physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, certified nurse midwives, clinical social workers, and clinical psychologists.

This solution will allow you to search monthly for Medicaid Enrolled providers and provide you with an enhanced way to track your providers Medicaid Enrollment dates. Thus, eliminating your concerns that your claims will be denied because the provider is not enrolled. It will allow users to begin searching and verifying a list of active Medicaid Fee-for-Service (FFS); Managed Care Only; and Ordering, Prescribing, Referring, Attending (OPRA) providers.

OPMC investigates complaints about physicians, physician assistants and specialist assistants and monitors practitioners who are subject to Orders of the State Board for Professional Medical Conduct. Kchecks provides a listing of all physicians, physician assistants, specialist assistants, and professional medical corporations who have been disciplined since 1990, or who are subject to a non-disciplinary Board Order, or upon whom charges of misconduct have been served.

Track all the licenses in your organization, keep notes and receive email alerts at intervals you determine.

Use these credits to verify your medical license data against a national database, no minimum or maximum purchase required.