Ohio CMS Medicare Opt-Outs | Onboarding

Ohio CMS Medicare Opt-Out | FAQ

This section explains how participation in the CMS Medicare Opt-Out program may impact your ability to work with Kindred Connections Therapy Center.

Some providers choose to opt out of Medicare under the assumption that it is required to avoid working with Medicare clients. In doing so, they enter into private pay agreements with clients and operate outside of Medicare billing guidelines. While this is an available option, it is not required to decline Medicare clients and may limit certain professional opportunities.

⚠️ Kindred Connections Therapy Center is unable to partner with providers who are currently listed on the CMS Medicare Opt-Out registry due to regulatory and payer-related requirements.

If you have previously opted out and would like to reverse that status, you must follow the official CMS process to cancel your opt-out designation. Once your status has been updated and verified, you may proceed with credentialing or partnership consideration.

What does it mean to opt out of Medicare?

Opting out of Medicare means that a provider has formally chosen not to participate in the Medicare program. As a result, services provided are not billed to Medicare, and clients are responsible for paying out of pocket. A written agreement is typically established between the provider and the client acknowledging that Medicare reimbursement will not apply.

Things to consider before opting out

Before making the decision to opt out, providers should understand the long-term implications. Opt-out periods generally last for two years and are not easily reversed unless specific conditions are met early in the process. This decision may also limit your ability to participate in certain insurance networks or programs connected to Medicare.

Additionally, providers who plan to work with Medicare Advantage plans or services covered under traditional Medicare guidelines may not be eligible to opt out while participating in those programs.

Why does opt-out status matter?

Many insurance networks and payer systems are connected to Medicare in some capacity. Providers who are listed as opted out may face limitations in joining or maintaining participation within these networks.

From an operational standpoint, opt-out status can also create inconsistencies in billing practices, disrupt care coordination efforts, and impact client access to services. For these reasons, Kindred Connections Therapy Center requires providers to maintain eligibility that aligns with payer expectations.

What if I am currently opted out?

If you are currently listed on the CMS Medicare Opt-Out registry, your eligibility to work with Kindred Connections Therapy Center may be impacted. Providers in this status are encouraged to begin the process of removing their opt-out designation if they wish to move forward with credentialing or collaboration.

Documentation of your removal request may be required as part of the verification process.

How do I remove my opt-out status?

To remove your name from the CMS Medicare Opt-Out list, you will need to follow the official cancellation process outlined by CMS. This typically involves submitting a written request within the designated timeframes.

Once your status is no longer active, you may proceed with credentialing steps as needed.

Can I choose not to accept Medicare and still work with Kindred Connections Therapy Center?

Yes. Providers are able to determine which insurance plans they accept as part of their practice preferences. Choosing not to accept Medicare does not require you to opt out of the program.

You can indicate your preferences during credentialing and adjust your referral settings accordingly while remaining compliant with payer and network requirements.