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Posting Date: 06/10/2019
Terminating (Dissolving) Practice and/or Retiring
Terminating (Dissolving) Practice and/or Retiring Terminating Sole-Owned or Sole-Proprietor Practice and Retiring Download CMS-855I. Complete sections 1A, 2A, 13 and 15B (update addresses in 2D, 2E, 4B, 4C). Terminating Practice ONLY [...]
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Posting Date: 10/24/2019
Ordering and Referring Provider
Ordering and Referring Provider Download CMS-855O. Complete section 1A and follow instructions. Reviewed 7/29/2024
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Posting Date: 04/14/2022
View Existing Medicare ID (PTAN) in PECOS and Effective/End Dates for Reassignment
View Existing Medicare ID (PTAN) in PECOS and Effective/End Dates for Reassignment Important: If you recently submitted an application to request a PTAN, please verify the approval letter was received prior to submission of claims. Log into [...]
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Posting Date: 12/22/2018
Legal Business Name Match
Legal Business Name Match Medicare enrollment success starts with you. It is vital that any time you are asked to supply your LBN or legal name, you indicate the name exactly as it appears at the IRS or the Social Security Administration [...]
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Posting Date: 12/11/2019
Participating Status on Provider Enrollment Approval Letters
Participating Status on Provider Enrollment Approval Letters If the Medicare Participating Physician or Supplier Agreement (CMS-460) is not submitted during initial enrollment or during the annual participation open enrollment period, the [...]
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Posting Date: 02/01/2021
Instructions for Unfinished PECOS Enrollment Application(s)
Instructions for Unfinished PECOS Enrollment Application(s) Table of Contents Instructions for Unfinished PECOS Enrollment Application(s) Instructions For Unfinished PECOS Applications Instructions For Application Status “Pending [...]
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Posting Date: 06/03/2021
PECOS Correct and Resubmit Application Instructions
PECOS Correct and Resubmit Application Instructions Login to PECOS and select the following: My Associates View Enrollment for applicable enrollment under Existing Associates Correct and Resubmit for [...]
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Posting Date: 05/04/2021
Provider Enrollment Application Process Timeline
Provider Enrollment Application Process Timeline All MACs, including National Governments Services, have a goal to finalize an Internet-based PECOS application within 15 days and a CMS-855 paper application within 30 days, if all required [...]
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Posting Date: 12/03/2020
Accreditation of Advanced Diagnostic Imaging and FDA Mammography Equipment
Accreditation of Advanced Diagnostic Imaging and FDA Mammography Equipment Reminder, if a hospital, clinic/group or Independent Diagnostic Treatment Facility has ADI screening equipment, certification from a designated ADI accrediting [...]
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Posting Date: 07/27/2020
PECOS Application Status Tool
PECOS Application Status Tool The status of your application is indicated by the step that is highlighted. If an application fee is required, an additional step will be added and the system will generate 5 steps. Your application was [...]
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Posting Date: 01/08/2019
Information for Physicians Who Refuse to Enroll, Opt-Out of the Medicare Program, or Submit Claims to Medicare
Information for Physicians Who Refuse to Enroll, Opt-Out of the Medicare Program, or Submit Claims to Medicare We have received inquiries asking whether physicians may refuse to enroll in Medicare and refuse to submit claims to Medicare when [...]
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Posting Date: 03/15/2024
Revalidation Application Checklist
Revalidation Application Checklist Use the Revalidation Application Checklist to assist when revalidating your enrollment information. The general checklist will allow you to understand requirements while the PECOS and CMS-855 paper checklist [...]
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Posting Date: 04/26/2019
Issues with Medicare Beneficiary Submitted Claims - We Need Your Help
Issues with Medicare Beneficiary Submitted Claims ‒ We Need Your Help Table of Contents Issues with Medicare Beneficiary Submitted Claims ‒ We Need Your Help Summary of Beneficiary Submitted Claims Related Content NGS Provider [...]
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Posting Date: 08/08/2023
Introducing PECOS 2.0
Introducing PECOS 2.0 PECOS 2.0 will make the Medicare enrollment and revalidation processes faster and more efficient. For more information, visit Introducing PECOS 2.0. Revised 7/29/2024
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Posting Date: 03/08/2021
Understanding Authorized Official and Delegated Official Roles
Understanding Authorized Official and Delegated Official Roles Table of Contents Understanding Authorized Official and Delegated Official Roles Medicare Enrollment Records CMS Identity and Access Management System [Return to Top] [...]
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Posting Date: 11/15/2021
Change of Tax ID Instructions and Forms
Change of Tax ID Instructions and Forms Table of Contents Certified Providers and Certain Other Suppliers Clinics/Group Practices Sole Owner/Sole Proprietor Effective Dates When Changing a Tax ID For Clinics/Group Practices [Return [...]
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Posting Date: 08/27/2021
Ordering and Referring Points of Interest
Ordering and Referring Points of Interest Per MLN SE18008, MACs will process CMS Form-855O provider enrollment applications submitted for unlicensed residents if the application submission includes either: A residency contract signed and [...]
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Posting Date: 07/13/2022
MSP Payment and Savings Calculator Bottom
How to Determine the Medicare Secondary Payment Amounts First, the MSP payment is determined by the following: Actual charge by physician/supplier or OTAF minus amount paid by primary Usual Medicare payment determination Fee [...]
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Posting Date: 09/26/2023
Adding or Terminating a Reassignment to an Established Group
Adding or Terminating a Reassignment to an Established Group Table of Contents Adding Reassignment Terminating Reassignment (By Individual) Terminating Reassignment (By Organization) Terminating Physician Assistant Employment Arrangement [...]
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Posting Date: 03/12/2019
CMS-855I Completion Tips for Managing Employee Information in Section 6
CMS-855I Completion Tips for Managing Employee Information in Section 6 Table of Contents Section 6: Managing Employee Information Instructions for Completing Section 6 Section 6A ‒ Managing Employee Identifying Information Section [...]
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Posting Date: 04/16/2019
CMS-855I Completion Tips for Physicians and NPPs that Reassign All Benefits Revalidation Application
CMS-855I Completion Tips for Physicians and NPPs that Reassign All Benefits Revalidation Application Follow the instructions printed on the CMS-855I application and refer to this list of sections required for revalidation. Sections [...]
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Posting Date: 07/30/2019
CMS-855O Completion Tips for Physicians or Eligible Professionals for the Sole Purpose of Ordering, Certifying or Prescribing Part D Drugs
CMS-855O Completion Tips for Physicians or Eligible Professionals for the Sole Purpose of Ordering, Certifying or Prescribing Part D Drugs CMS-855O is a national enrollment; providers who relocate to another state are not required to disenroll [...]
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Posting Date: 02/18/2021
CMS-855B Completion Tips for Clinics/Group Practices and Other Suppliers Revalidation Application
CMS-855B Completion Tips for Clinics/Group Practices and Other Suppliers Revalidation Application Follow the instructions printed on the CMS-855B application and refer to this list of sections required for revalidation. Section [...]
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Posting Date: 07/29/2024
Resolving PECOS Common Errors and Warnings
Table of Contents Error/Warning PECOS Reference Guide and Help Desk Information [Return to Top] Error/Warning Error indicated, correct all topic errors Warning indicated, verify information for accuracy PECOS Topic [...]
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Posting Date: 11/14/2019
Understanding Participating, Nonparticipating and Opt Out Status
Understanding Participating, Nonparticipating and Opt Out Status Principles Participating Status Nonparticipating Status Opt Out Status Explanation When a physician/practitioner enrolls as a new provider in [...]
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Posting Date: 08/23/2018
Medicare Provider/Supplier Specialty Codes
Medicare Provider/Supplier Specialty Codes Here is the list of Medicare provider/supplier specialty codes you can use as a reference during the enrollment process. Code Description 01 General practice 02 [...]
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Posting Date: 05/11/2021
Medicare Provider/Supplier Provider Type Codes
Medicare Provider/Supplier Provider Type Codes Below is the list of Medicare provider/supplier type codes you can use as a reference during the enrollment process and claims processing. Code Description 20 [...]
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Posting Date: 03/13/2017
CMS-855B Completion Tips for Ownership Interest and/or Managing Control Information
CMS-855B Completion Tips for Ownership Interest and/or Managing Control Information Table of Contents Section 5 – Ownership interest and/or managing control information Instructions for Completing Section 5 Section 5A - [...]
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Posting Date: 02/04/2021
Supporting Documentation Required for Enrollment Revalidations
Supporting Documentation Required for Enrollment Revalidations Submit all required documentation based on your revalidation scenario: Written confirmation from the IRS confirming your legal business name and EIN (e.g., IRS CP-575) The [...]
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Posting Date: 08/10/2020
Learn About PECOS Web
Learn About PECOS Web Table of Contents CMS Provider Enrollment Systems Advantages of Online Enrollment Get Started Other Resources Get Access Password Requirements Multi-Factor Authentication Get Help [Return to [...]
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Posting Date: 02/02/2021
Approval or Denial
Approval or Denial Approval Once your application is approved, you will receive an email containing a Medicare letter with PTAN. Review this letter to ensure that everything is accurate and if you have any questions, please contact the [...]
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Posting Date: 02/02/2021
Acknowledgement Email
Acknowledgement Email Upon receipt of your application submission, the contact person (identified on application) will receive an email confirmation from: NGS-PE-Communications@elevancehealth.com containing the NGS case number for tracking [...]
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Posting Date: 02/04/2021
CMS-855I Completion Tips for Physicians and NPPs in Private Practice (Sole Owner or Sole Proprietor) Revalidation Application
CMS-855I Completion Tips for Physicians and NPPs in Private Practice (Sole Owner or Sole Proprietor) Revalidation Application Follow the instructions printed on the CMS-855I application and refer to this list of sections required for [...]
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Posting Date: 02/26/2020
Description of Revalidation
Description of Revalidation Section 6401(a) of the Affordable Care Act requires that all enrolled providers or suppliers revalidate their Medicare enrollment information under new enrollment screening criteria. To maintain Medicare billing [...]
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Posting Date: 03/04/2022
Revalidation Request Mailed
Revalidation Request Mailed We will mail the revalidation notices to identified providers and suppliers currently enrolled in the Medicare Program. The revalidation notice will be sent two to three months prior to due date. Each provider or [...]
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Posting Date: 03/04/2022
How Will You Know it is Time to Revalidate
How Will You Know it is Time to Revalidate We will contact each provider or supplier when it is time to revalidate their enrollment information by sending a revalidation notice with a revalidation due date. We will send the [...]
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Posting Date: 11/29/2021
How to Search on the Medicare Revalidation List Tool for Due Date
How to Search on the Medicare Revalidation List Tool for Due Date Table of Contents How to Search on the Medicare Revalidation List Tool for Due Date Find a Provider By NPI By Name Associated Datasets [Return to Top] How [...]
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Posting Date: 10/20/2021
Cognitive Assessment
Cognitive Assessment Table of Contents Billing Codes Billing Information Documentation Related Content [Return to Top] Billing Codes 99483: 60 minute face-to-face [Return to Top] Billing Information Cognitive assessment [...]
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Posting Date: 11/19/2021
Paper Enrollment Process
Paper Enrollment Process Paper-based enrollment applications are available. Submitting your enrollment via paper is an option, but PECOS is the preferred method to process the application with streamlining features. Determine which CMS-855 [...]
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