medicare status - are there really 4?

[Guest guest]

I know we've discussed this frequently in the past, but I talked to a

Medicare rep for Virginia on the phone yesterday and this was the

information I took home from the conversation and just wanted to run

it by the group. My situation is that I work full time for an UC

practice who bills medicare for the services I provide with a medicare

number. I wondered if I needed my own number to see Medicare

patients. I plan to not accept any insurance including medicare as

payment, but didn't want to commit " fraud " or some such nonsense by

seeing medicare patients and having them pay me directly with the

understanding that they could not receive reimbursement from Medicare

for these services. Talking to the rep we discussed the 3 options

associated with registering with Medicare: par, non-par and opting

out. Understanding that if I register and opt out, I could not decide

to become non-par (if my practice developed in a way to make this

reasonable) for 2 years, I asked about simply not registering as a

medicare provider and not having a medicare number for my housecall

practice. He couldn't see any problem with this as long as the

patient understood I had no contract with Medicare at all and that

they could not be reimbursed by Medicare for my services. According

to the rep, I wouldn't even need the personal contract with the

patient that opt out MDs must have as I would be totally outside the

medicare system with no contractual relationship between Medicare and

myself. Although, I may draw up a simple acknowledgement form or

contract for medicare patients to sign just to cover my ass. This

seems to make sense to me, but knowing how screwed up our system is by

lawyers and arcane regualtions, I wondered if it is correct?

Straz