Medicare enrollment decision time is now

May 19, 2016
It's time to make your decision about Medicare enrollment. Will you opt out, forcing patients to pursue other dental providers, or will you enroll? If you choose the latter, Louis Malcmacher, DDS, MAGD, encourages you to consider outsourcing your Medicare enrollment to professionals like those at STATDDS.
It's time to make your decision about Medicare enrollment. Will you opt out, forcing patients to pursue other dental providers, or will you enroll? If you choose the latter, Louis Malcmacher, DDS, MAGD, encourages you to consider outsourcing your Medicare enrollment to professionals like those at STATDDS.

The August 2016 Medicare application deadline date is coming up, and your patients will soon be asking you about the irritating letters they will be receiving from Medicare, which can affect your relationship with these patients. The American Dental Association (ADA) and the Centers for Medicare and Medicaid Services (CMS) have strongly encouraged dentists to enroll with Medicare by August 2016 so as not to disrupt the benefits of the millions of patients enrolled in Medicare Part D when the enforcement date kicks in on February 1, 2017.

Here is a very quick recap of my previous Medicare articles: (1) You need to get this done now; (2) each practice owner needs to decide what is best for his or her practice; (3) your Medicare patients will leave you if you do nothing; and (4) the right choice will bring many new patients to your office.

Here is what will happen if you do nothing regarding Medicare. After February 1, 2017, the first time you write a prescription for a patient with a Medicare Part D drug plan, the patient will get a provisional supply of the prescribed drug and will receive a letter stating that the drug will not be covered again after the first three months because the prescribing dentist is not enrolled. You will receive a letter from Medicare as well since Part D plans are also required to attempt to notify the prescribing dentist. After three months, the patient's Medicare prescription plan will deny coverage of the prescription. How happy do you think the patient will be with your office? I can guarantee that he or she will find another dentist very quickly.

If you opt out of Medicare, you will be excluded from the many Medicare advantage dental plans your office has right now. This will force patients to seek other dental providers. These patients will not receive any dental benefits if you opt out of these plans, so they will come to offices like mine that have enrolled in Medicare. You will be locked out of these plans for two years! The chances of you ever seeing these patients again are nonexistent.

RELATED | This dental practice opted out of Medicare. Any way back in?

Medicare STATistics

The bottom line is that you need to submit your Medicare application immediately. Here are the latest dental statistics from the STATDDS Medicare enrollment specialists who have helped enroll thousands of dentists over the past two and a half years:

• 97.4% of dentists enrolling in Medicare Part B chose to enroll as ordering/prescribing providers.

• 1% of dentists chose to opt out of Medicare.

• 1.6% of dentists chose to enroll in Medicare as billing providers.

How to ramp up hygiene production Medicare enrollment decision time is now

• 94% of STATDDS clients who first tried to submit Medicare applications themselves were rejected by Medicare; the other 6% successfully enrolled into the wrong Medicare choices and wanted to change enrollment before they lost patients.

• 38% of dentists enrolling with STATDDS in Medicare Part B also chose to submit a Medicare durable medical equipment (DME) application at the same time to be able to bill Medicare for oral appliances for dental sleep medicine.

Medicare horror stories

I have heard some dentists' Medicare horror stories. One dentist submitted the wrong enrollment to Medicare, which resulted in being locked out for two years. Another dentist submitted an application with the wrong information, which resulted in months of rejection letters and hours of wasted time. One dentist reported that he could have produced an additional $10,000 in dentistry in the time that it took him to file and try to correct his Medicare application. He finally gave up and asked STATDDS to step in; STATDDS finished the application in three weeks.

STATDDS reports that Medicare is currently taking approximately four to six months to process Medicare Part B applications. This means that if you begin to get your application together now, you will be able to make the deadline on August 1, 2016, so your office can be approved by the enforcement date of February 1, 2017. You can then inform all of your Medicare patients that they can tell their Medicare friends that your office can take care of all of their dental needs.

RELATED | Do you write prescriptions for seniors? Make sure your dental practice is enrolled in Medicare

This is exactly why I have been recommending from the start to hire Medicare professionals like STATDDS so you can get it right the first time. There is no dentist I know who would do his or her own legal work, office accounting, or taxes. Outsourcing Medicare enrollment to professionals will save you time, money, and aggravation.

Louis Malcmacher, DDS, MAGD, is a practicing general dentist and an internationally known lecturer and author. Dr. Malcmacher is the president of the American Academy of Facial Esthetics (AAFE) and a consultant for STATDDS. You can contact him at (800) 952-0521 or e-mail [email protected]. You can also visit to download his resource list, sign up for a free monthly newsletter, or find information about live-patient frontline TMJ/orofacial pain, Botox and dermal fillers training, dental implant training, frontline bruxism therapy and dental sleep medicine, and medical insurance.

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