What does it mean if a facility is designated as a participating supplier for Medicare?

A facility designated as a participating supplier for Medicare means that it agrees to accept the Medicare allowable amount as payment in full for covered services. This designation ensures that the provider will not bill the patient for any amount exceeding the Medicare rates, instead accepting Medicare’s established reimbursement amounts as final.

This arrangement benefits patients, as it provides assurance that their out-of-pocket expenses will be minimized. Participating suppliers are also required to file claims on behalf of the patients they treat, streamlining the payment process. By being a participating supplier, the facility commits to a set of terms that align with the goals of Medicare to provide cost-effective and accessible healthcare services to beneficiaries.

In contrast, other scenarios in the choices provided involve policies that do not apply to participating suppliers, such as the freedom to charge any amount, the possibility of refusing Medicare patients, or receiving additional benefits beyond those established for participation.