41 Step Guide to Become a Medicare Provider w/ Screenshots – Optometry

guide-to-becoming-medicare-provider

Becoming credentialed as an optometrist with Medicare can be difficult. I would say it was one of the most difficult insurance carriers I joined. If you get it right the first time, you are in the clear with no worries. Mess up just once and you immediately delay the process by 3 months and lots of headaches!

  • Credentialing with Medicare takes about 60 – 120 days from the time you submit your application
  • You can do it online or on paper. The online version uses the PECOS system and the paper version requires forms CMS-855I form
  • The people at Medicare phone support are actually the most helpful and knowledgeable of any insurance company I have dealt with
  • You will need your state license, your NPI number and a good idea of your short term employment situation

The guide below is meant to be for optometrists who are considered “Employees” and not “Independent Contractors”. The 2 are similar, and this guide will help you regardless of which type of provider you are.

Also, this guide is for people using the PECOS online system, not the paper application.

If you are an independent contractor, you should follow this guide on how to become a medicare provider.

Read Yellow Box Before Proceeding

A message from the author – this is my personal experience with the Medicare application process. I am in no way, giving you instructions for how YOU should apply. I am simply showing you the exact way that I went about it.

You need to understand that if you mess up the application process, it can really hurt your practice because you will not be able to see Medicare patients. Not having access to those patients can financially hurt your practice in more ways than one…. I am not responsible if that happens to you.

If you are not prepared to claim responsibility for yourself then DO NOT use this article to help you. In all honesty, I know that this article will be helpful for you. It will speed up the process and help you nail it first try. It took me over 1 year to get on Medicare because of the mistakes I made, so I highly recommend using this article to avoid those same mistakes.

There is no guarantee the article is error free. NewGradOptometry.com, its sponsors, advertisers, staff and writers make no representation, warranty, or guarantee that this article and its contents are error-free and will bear no responsibility or liability for the results or consequences of the information contained within. – Matt Geller O.D.

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About Matt Geller

Matthew Geller
Dr. Matt Geller is a technology entrepreneur with a track record of developing successful online platforms to solve problems in the healthcare space. Matt is an optometrist in San Diego and is the founder of OptometryStudents.com, NewGradOptometry.com and the co-founder of CovalentCareers.com!

6 comments

  1. I was wondering what was the Medicare support line phone number? I can’t find any contact number on the website. Thanks.

  2. If I’m waiting for my license, can I begin filling out the Medicare online application? Is there a “save” function?

  3. Hi, first, thank you SO much for this page. I recently received an email saying that my application’s final status is approved and I received my medicare ID number. Does this mean I can starting scheduling and seeing medicare patients? Or are there any more paperwork to complete prior to this process? Thanks again

    • Matthew Geller

      Hey Jim! If you got your Medicare NPI / PTAN than you are all ready to start scheduling and seeing patients! I would submit a few claims to make sure you are getting paid prior to really booking your schedule solid. Once you know you are getting reimbursements let the flood gates open!

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