Credentialing
MEDICARE REVALIDATIONS-Is your Practice Ready?
By Machelle Giordon
Is your practice prepared for the upcoming Medicare Revalidation Process? Medicare will soon begin sending out notices to practices requiring revalidation of enrollment forms.
Many practices have not updated their records with Medicare for many years. In some instances when an application was made to obtain an NPI number, the federal tax identification number was submitted as part of the records. The number on the application did not match the record on file with Medicare. For example, if the provider was previously a sole proprietor, then the Social Security number may still be on file with Medicare. As a result there have been delays in payment, or worse yet, no payments have been made to the practice. Therefore, it is imperative to you update records on an ongoing basis with Medicare. This can be done by completing an 855 form and sending it to Medicare. The 855 forms can be obtained by contacting Medicare Provider Enrollment at 866-308-5439 or their website www.cms.hhs.gov/comforts We suggest you start to prepare for this eventuality NOW:
- Make sure you are currently and properly enrolled with Medicare and that all changes- addresses, provider information, etc. have been submitted and approved by Medicare.
- Make sure the Legal Business name shown on your IRS form- CP575- perfectly matches the name on file with NPESS (NPI)-down to the exact punctuation. What is a CP575? It is the confirmation document that was received from the IRS when the tax id number was assigned. If a copy can not be located, call the IRS for assistance at 800-829-4933 and request a copy of the letter to have on file in the office.
Take the time now to get the paperwork in order so that if a request is received, the staff will be able to respond to it promptly. By not doing so, cash flow could be jeopardized and ultimately participation in Medicare.
O’Sullivan Consulting Group can assist providers in dealing with some of the additional demands of managed care plans and credentialing. For further assistance please contact Machelle at 330-723-2111 or machelle@osullivanconsult.com
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