Medicare Compliance & Reimbursement

If you think that your Medicare provider revalidation process is complete once you submit your CMS-855 form, think again.

Context: Medicare Administrative Contractor (MAC) NGS Medicare reminds that after you submit the correct CMS-855 form, which is determined by provider or supplier type, there’s another step. “Upon receipt of the application, the requirement of submission is met by an acknowledgement email to the contact identified on the application with the case number,” the Part B MAC notes in a June 7 alert. “The provider/ supplier shall follow the status of the application to respond to additional information requested, if needed. When processing is complete, the contact will receive an approval or approval recommendation letter via mail, fax or email.”

Tip: Having one contact person that interacts with your MAC can help with communication and act as a touch point on all things Medicare. In addition, you may want to review your MAC’s resource on provider enrollment and revalidation as each individual carrier has specific look-up tools and processes. If you misplace your case number and tracking information, you should be able to find revalidation data with a valid National Provider Identifier (NPI) and Tax Identification Number (TIN).

Find out more about revalidation and review the various CMS-855 applications at www.cms.gov/Medicare/Provider- Enrollment-and-Certification/Enrollment-Applications.