Provider Enrollment Reconsideration Request Reminders

National Government Services has been receiving reconsiderations of provider enrollment credentialing requests that do not fall into the appropriate criteria for reconsiderations due to the signature on the request. 

Please remember that any Provider Enrollment Reconsideration requests must:

• Be received in writing within 65 calendar days from the date of the determination letter and mailed or emailed to the address indicated in that letter.
• State the issues or findings of fact with which you disagree and the reasons for disagreement.
• Be signed by the provider or supplier, an authorized or delegated official that has been reported within your Medicare enrollment record, or an authorized representative.
  • If the authorized representative is an attorney, the attorney’s statement that he or she has the authority to represent the provider or supplier is sufficient to accept this individual as the representative.
  • If the authorized representative is not an attorney, the individual provider, supplier, or authorized or delegated official must file written notice of the appointment of its representative with the submission of the reconsideration request.
  • Authorized or delegated officials for groups cannot sign and submit a reconsideration request on behalf of a reassigned provider/supplier without the provider/supplier submitting a signed statement authorizing that individual from the group to act on his/her behalf.

Please especially take note of the last item listed, as we have seen many requests that do not meet this criteria.

For more information read the Provider Enrollment Appeals Process.

Posted 10/7/2020