Provider Enrollment: Top Reasons Behind Delays in Processing the Application
Medicare enrollment plays a vital role in ensuring compliance with CMS requirements. To help streamline the process and achieve the best results, it's important to submit all necessary information and documentation with your enrollment application, whether electronically in PECOS or on the paper CMS-855. By focusing on the details of your application type and verifying information carefully, you can enjoy a quicker and more efficient processing experience.
Below are common reasons for development:
Reason | Resolution |
---|---|
Missing AO/DO information | Verify complete and accurate information is provided in the individual control topic in PECOS or in section 6 on the CMS-855 paper application. Missing information may include percent of ownership, SSN/DOB, relationship to the applicant. |
Incomplete Signature and Date | Verify the Authorized and/or Delegated Officials signs and dates the application, including any newly added AO/DO. |
Application Fee | Determine if an application fee is required by using the Application Fee Decision Tree Tool |
Attachment 1 SNF information and/or missing Organizational Charts | SNF specialty must complete attachment 1
A SNF must submit the below identifying charts:
|
Missing required supporting documents | Depending on the enrollment specialty and type of application submitted examples are:
Review the article Supporting Documentation Information for assistance |
Missing medical directors and/or administrators for a Hospice or SNF |
PECOS identify under the individual control topic. CMS-855A paper application
|
Resources on our website to assist with application submission:
- Provider Enrollment Topics/Steps and Events
- YouTube presentations:
Posted 3/17/2025