Thursday, October 9, 2014

Do you treat patients over the age of 65?

Does your practice treat patients that are over the age of 65? If you do, you have a deadline to meet. On June 1, 2015 Medicare is going to get all up in your business and you better be prepared because if you have ever dealt with government paperwork, you know it can be a long process.

Now you might be thinking, “We don’t bill Medicare so how will this affect me?” Well, if you write prescriptions to patients who have Medicare Part D prescription coverage, these prescriptions will not be covered. If you perform a Medicare covered service (such as biopsies, CT scans, some TMJ services, and airway appliances), these services will be denied and you will not be able to bill the patient. This is how Medicare will affect you and your patients.

What you need to know . . .

You have three choices when it comes to deciding which way your office is going go with the June 1st deadline.
  1. You can enroll as a Medicare provider. If you choose this path, your office will be required to comply with all Medicare regulations, including the fee schedules.
  2. You can opt-out as a Medicare provider. If you choose this, you will be required to fill out an affidavit every two years to keep it current and you will be required to enter an opt-out contract with each Medicare covered patient you treat in your practice.
  3. You can choose to be an ordering/referral provider if your office does not perform any Medicare-covered procedures or prescribe medication but you may refer to doctors that do.

The path will be different for each office so I am going to give you some resources so you can do some research and find out which path is best for your office. Also, if you are looking for advice on what is best for you, I am providing two amazing industry leaders in this topic you can contact.
CLICK HERE for enrollment

For one-on-one coaching on this topic:

Teresa Duncan

Terri Bradley

Christine Taxin



Dayna Johnson, Certified Dentrix Trainer
Dayna loves her work. She has over 25 years of experience in the dental industry, and she’s passionate about building efficient, consistent, and secure practice management systems. Dayna knows that your entire day revolves around your practice management software—the better you learn to use it, the more productive and stress-free your office will be. In 2016, Dayna founded Novonee ™, The Premier Dentrix Community, to help cultivate Dentrix super-users all over the country. Learn more from Dayna at and contact Dayna at


  1. To treat patients over the age of 65, we need a proper dental consultants. One of the best dental experts can provide any dental office with full service dental practice management consultants and can can also demonstrate how to treat any senior citizen patient.

  2. Do you know where once can easily find the medicare fee schedule?
    It seems like Medicare doesn't cover cleanings, X-rays, fillings and crowns. If the office doesn't do anything that is covered by Medicare, is there any harm/liability in choosing option #1 above?

    If choosing option #2, do you know of a link to a sample contract that can be used for each Medicare patient we have? Do you personally think opting out and having the patients sign a contract will reflect poorly on the office?

    1. Great questions. Medicare typically does not cover dental procedures. The most common procedures being covered by Medicare in the dental office are sleep apnea appliances, some TMJ and biopsies.

      There is no harm in choosing any of the options, there is harm in not doing anything.

      I don't think opting out and having the patient sign a contract will reflect poorly on the office, however every office is different and should make the decision based on the type of practice it is. My office was an opt out office and we had the patients sign an affidavit. They could still bill Medicare for services but our office did not have to do the write off.

      Hope this helps.

    2. I can not find the Opt Out form. The email address you gave in the most recent email is coming back as 'Not Deliverable Permanently'. What site do I go on to Opt out?

    3. Try this:

  3. we are getting ready to enroll as a single provider/private practice, please send me the link for the enrollment. Also we are thinking of option#3? We will not enroll for the fee for service but would like to be able to write a prescription for our 65+ yr patients

  4. We are wondering if we choose to be a Medicare Part B solely to order and referer services will this affect anything if the patient has a medicare supplement coverage that has some dental on it,or will everything remain the same as it is now?

    1. It will not affect their Medicare supplement dental coverage. If you want more information there is a webinar coming up on April 30th you might be interested in.

      Hope this helps