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Can I see Medicare clients under CCS?

Understanding Medicare Eligibility at CCS

At this time, CCS is only in-network with Kaiser Medicare for members residing in the Denver/Boulder region. We do not currently process claims for traditional Medicare or other Medicare Advantage plans.

To see and bill these specific Kaiser Medicare clients, you must meet all three of the following conditions:

  1. Initial Request: you must have explicitly requested to be in-network with Kaiser Medicare during your initial credentialing process with CCS.

  2. Roster Status: You must be confirmed as "OPEN" for Kaiser Medicare on Kaiser’s official credentialing directory and roster.

  3. CMS Status: You must have never formally opted out of Medicare through CMS. If you have previously opted out, you are legally ineligible to bill any Medicare-funded plan, including Kaiser's.

Why These Rules Exist

Medicare billing is strictly regulated at the federal level. If a provider has opted out of the federal Medicare program, no insurance carrier (including Kaiser) is permitted to reimburse them using Medicare funds. Verifying your "Open" status on the roster ensures that claims will not be immediately rejected for provider eligibility issues.