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: If an individual provider needs to reassign benefits If an individual provider is new to Medicare and reassigning benefits- refer to: How to Determine if the Provider is Active and Get the Provider Enrolled in Medicare Part B
Missing dependent CMS-855B application	CMS-855I needs dependent CMS-855B application: Individual reassigning to an entity that is not enrolled PECOS submission for updates to a sole owned entity’s enrollment information
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: Diploma and National Board Certification for a nonphysician State Temporary License DEA IRS (CP575, CP147c, SS-4) identifying current legal name and TIN/EIN Voided check or bank confirmation letter with submission of the CMS-588 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: SSA office for the individual biller IRS document for the sole proprietor using an EIN IRS document for the entity

Resources on our website to assist with application submission:

Revised 3/17/2025

Back to News