Medicare + Medicaid Provider Enrollment
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, with final notices having been mailed on March 23, 2015. As status quo is not in the CMS vocabulary, Revalidation Cycle 2 is underway 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!
Tips to Facilitate the Medicare Enrollment or Revalidation Process
- 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.
- Submit the current version of the Medicare enrollment application (CMS-855).
- Submit the correct application for your provider or supplier type to the Medicare fee-for-service contractor servicing your State or location.
- Submit a complete application.
- Request and obtain your National Provider Identifier (NPI) number before enrolling or making a change in your Medicare enrollment information.
- Submit the Electronic Funds Transfer Authorization Agreement (CMS-588) with your enrollment application, if applicable.
- Submit all supporting documentation.
- Sign and date the application.
- Respond to fee-for-service contractor requests promptly and fully.
- 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.
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. If you have any questions, please contact us.- Responsibility, Arranger, Includer, Harmony, Communication