LUTZ BUSINESS INSIGHTS

 

enrollment

Provider Enrollment

KIRK DELPERDANG, HEALTHCARE director

 

Medicare Provider Enrollment

Have you ever had that feeling of déjà vu?  If you work in healthcare, especially in Medicare, we know you have.  Your facility and practitioners have likely experienced the opportunity to revalidate Medicare enrollment information to your MAC during the first revalidation cycle which started on March 25, 2011 and is wrapping up currently, with final notices having been mailed March 23, 2015.

As status quo is not in the CMS vocabulary, Revalidation Cycle 2 is under way in early 2016.  CMS has standardized, improved and streamlined the process this time to reduce provider/supplier burden.  For example, due dates are established and posted to the CMS.gov Lookup Tool.  The dates are posted up to six months before your revalidation date, allowing for appropriate preparation time.  All due dates are on the last day of the month.  For consistency, due dates will generally remain the same for subsequent revalidation cycles (yes, you will have the opportunity to do this again), so plan ahead!

General Tips to facilitate the Medicare Enrollment (or Revalidation) Process

  1. Consider using Internet-based Provider Enrollment, Chain and Ownership System (PECOS) to enroll or make a change in your Medicare enrollment if it is available for your provider or supplier type.
  2. Submit the current version of the Medicare enrollment application (CMS-855).
  3. Submit the correct application for your provider or supplier type to the Medicare fee-for-service contractor servicing your State or location.
  4. Submit a complete application.
  5. Request and obtain your National Provider Identifier (NPI) number before enrolling or making a change in your Medicare enrollment information.
  6. Submit the Electronic Funds Transfer Authorization Agreement (CMS-588) with your enrollment application, if applicable.
  7. Submit all supporting documentation.
  8. Sign and date the application.
  9. Respond to fee-for-service contractor requests promptly and fully.
  10. Visit the CMS.gov Lookup Tool (https://data.cms.gov/revalidation)

 

Medicaid Provider Enrollment

Lest you think Medicare’s “little brother”, Medicaid, was left out, don’t worry.

Nebraska Medicaid & Long-Term Care (MLTC) has contracted with Maximus to assist the Division in being compliant with the requirements mandated in 42 CFR, Subpart E-Provider Screening and Enrollment.  Effective December 1st, 2015, all service provider agreements must be submitted to Maximus, as opposed to Nebraska DHHS.  Providers can complete, submit, and update their service provider agreements electronically using the new NE Provider Screening and Enrollment web portal.

www.nebraskamedicaidproviderenrollment.com.  Nebraska Medicaid requires that all active providers

enrolled prior to March 25, 2011 and providers with enrollment end dates of 12/31/9999 must be revalidated prior to November 25, 2016.  Revalidations can be completed at any time using the Maximus

NE Provider Screening and Enrollment web portal.  Consistent with Medicare, these revalidations will occur at least every five years.  So, if you have not revalidated your facility Medicaid enrollments or you have suppliers under your enrollment purview, don’t delay.  Revalidate your Medicaid enrollments today to avoid a termination of your Medicaid enrollment.

 

Lutz Offers Healthcare Provider Enrollment Services

Lutz provides enrollment services for healthcare providers from small physician offices up to multi-campus healthcare systems and everything in-between.   Let Lutz guide you through the process and remove the burden from you and your staff.  Services include initial enrollments, revalidations, changes of information, reassignments, state applications and revalidations, and licensure services.

The Lutz enrollment team is headed by Kirk Delperdang, who has more than 20 years of professional experience in the healthcare industry.  His expertise is in Medicare reimbursement and Medicare compliance, including provider enrollment and licensure.

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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