Medicare enrollment is the first step towards becoming Medicare provider or supplier. CMS has shared complete process flow chart for successful Medicare enrollment. Being leading medical billing company, Medisys Data Solutions helped lots for providers and suppliers in successful Medicare enrollment. While assisting providers and suppliers, we found common mistakes made by providers or office managers during enrollment process. In this article, we shared basic tips that would help in successfully completing Medicare enrollment process. Some of the key element of Medicare enrollment process are as follows:
NPI
CMS requires that providers and suppliers obtain their National Provider Identifier (NPI) prior to enrolling or updating their enrollment record with Medicare. If you do not have an NPI, you can contact the NPI Enumerator at https://nppes.cms.hhs.gov
PECOS
Provider Enrollment, Chain and Ownership System (PECOS) allows physicians and non-physician practitioners to enroll, make change in their Medicare enrollment, or view their Medicare enrollment information on file with Medicare. In PECOS you will find all the required documents to fill all required information accurately. All information for PECOS can be found by logging on to the Medicare Provider and Supplier Enrollment webpage (www.cms.gov/MedicareProviderSupEnroll) and clicking on the Internet-based PECOS link located on navigation menu.
CMS-855
Submit the current version of the Medicare enrollment application i.e., CMS-855. Medicare enrollment application can be found at: http://www.cms.hhs.gov/CMSForms/CMSForms/list.asp
Submit to Correct Medicare Contractors
Submit the correct application for your provider or supplier type to the Medicare fee-for-service contractor servicing your State or location. The Medicare contractor that serves your State or practice location is responsible for processing your enrollment application. Applicants must submit their application(s) to the appropriate Medicare fee-for-service contractor. A list of the Medicare fee-for-service contractors by State can be found at https://www.cms.gov/medicare/provider-enrollment-and-certification/medicareprovidersupenroll/downloads/contact_list.pdf
Submit a Complete Application
If you are enrolled in Medicare, but have not submitted a CMS-855 or submitted an application via the Internet-Based Provider Enrollment Chain and Ownership System (PECOS) for a change of information or for revalidation, you are required to submit a complete application. Providers and suppliers should follow the instructions for completing an initial enrollment application. When completing a paper CMS-855 or an application via PECOS for the first time for any reason, each section of an application must be completed. When reporting a change to your enrollment information, complete each section listed in Section 1B of the paper CMS-855.
EFT Authorization Agreement
CMS requires that providers and suppliers, who are enrolling in the Medicare program or making a change in their enrollment data, receive payments via Electronic Funds Transfer (EFT). The CMS-588 must be signed by the authorized official that signed the Medicare enrollment application. Note that, if a provider or supplier already receives payments electronically and is not making a change to his/her banking information, the CMS-588 is not required.
Supporting Documents
In addition to a complete application, each provider or supplier is required to submit all applicable supporting documentation at the time of filing. Supporting documentation includes, if applicable, an authorization agreement for Electronic Funds Transfer Authorization Agreement (CMS-588). Only durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS)suppliers are required to submit the National Provider Identifier notification received from the National Plan and Provider Enumeration System.
Date and Signature
Applications must be signed and dated by the appropriate individuals. Signatures must be original and in ink (blue preferable). Medicare won’t accept copied or stamped signatures.
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Reference: Become a Medicare Provider or Supplier
