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 |
---|---|
Incomplete Signature and Date | Verify the Authorized and/or Delegated Officials signs and dates the application, including any newly added AO/DO. |
Missing dependent CMS-855I application(s) |
CMS-855B needs dependent CMS-855I application:
|
Missing dependent CMS-855B application |
CMS-855I needs dependent CMS-855B application:
|
NPPES name mismatch | NPPES website information must match for the NPI enrollment submission |
Missing required supporting documents |
Depending on the enrollment specialty and type of application submitted examples are:
Review the articles Supporting Documents and/or Eligible Nonphysicians for assistance |
Missing or Incorrect CMS-588 EFT information |
Verify all fields are complete and accurate Legal name on the bank account (void check/bank confirmation letter) must match:
|
Resources on our website to assist with application submission:
- Provider Enrollment Topics and Steps and Events
- YouTube presentations
Revised 3/17/2025