LUTZ BUSINESS INSIGHTS

 

PROVIDER ENROLLMENT UPDATE FOR 2022

provider enrollment update for 2022

kirk delperdang, healthcare director

 

Medicare Provider Enrollment

The Medicare provider and supplier enrollment process is a continuous one that requires ongoing attention, lest you be impacted by an interruption in reimbursement. Covid has interrupted, pressed pause, or otherwise impacted the provider enrollment process for the last two years, the same as with every other facet of healthcare and life. There have been efforts by CMS to expedite applications or allow for temporary enrollments in various cases to aid in the battle against Covid and get more help to the front lines as fast as possible. In other cases, CMS has slowed the enrollment process, temporarily suspending revalidations to allow efforts to be focused on other areas of healthcare and healthcare finance.

Here are some recent developments at CMS that you should be aware of in the Provider Enrollment arena:

 

Revalidations

CMS has resumed its revalidation activities and processes. Consistent with overall revalidations over the last decade, this is coming in a phased approach for existing providers and suppliers that missed their revalidation due date during the PHE. CMS began mailing letters in October 2021, with due dates in early 2022.

One plus side to this revalidation is that it does not apply to providers and suppliers that received temporary billing privileges through the Medicare enrollment hotlines. However, this is only a temporary stay.  Once the PHE is lifted, providers that were granted temporary billing privileges for Covid will need to submit a complete CMS-855 enrollment application to establish full Medicare billing privileges. MACs will be sending letters to specifically address these situations.

Notices – CMS will provide notice to providers and supplies in this first phase in two different ways:

  • Medicare Revalidation Tool at https://data.cms.gov/revalidation and,
  • Revalidation letters will be issued at least three months in advance of their due date to the correspondence address on file in your enrollment.

Ramifications – The revalidation process is again fully intact. Failure to respond by the due date results in the deactivation of Medicare billing privileges. No payments will be made for services provided while billing privileges are deactivated.

 

Application Fees

Application fees were suspended during the PHE. As of October 2021, CMS has resumed the collection of applications fees in accordance with the Medicare regulations. Please note that the application fee will continue to be waived for providers and suppliers who received temporary billing privileges through the Medicare enrollment hotlines.

Application Fee Matrix: https://www.cms.gov/files/document/applicationfeerequirementmatrixpdf.pdf

If you have any questions, please contact us. You can also learn more on related topics by visiting our healthcare blog.

ABOUT THE AUTHOR

402.496.8800

kdelperdang@lutz.us

LINKEDIN

KIRK DELPERDANG + HEALTHCARE DIRECTOR

Kirk Delperdang is a Healthcare Director at Lutz with over 28 years of experience. He provides healthcare enrollment services to clients with a focus on Medicare providers and reimbursement analyses. In addition, he is responsible for leading Lutz's cost report service line.

AREAS OF FOCUS
AFFILIATIONS AND CREDENTIALS
  • Healthcare Financial Management Association - Nebraska Chapter, Member
  • Nebraska Society of Certified Public Accountants, Member
  • Certified Public Accountant
EDUCATIONAL BACKGROUND
  • BA in Accounting, University of Northern Iowa, Cedar Falls, IA
COMMUNITY SERVICE
  • St. Vincent de Paul, Knights of Columbus, Member
  • Active in various youth sports leagues: Aldrich Elementary, Millard Athletic Association, Millard North Schools, Omaha FC, Skutt Catholic High School and YMCA

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