Avoid Missed Medicare Revalidation Deadlines

Updated: September 24, 2021
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Avoid Missed Medicare Revalidation Deadlines

Updated: September 24, 2021
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Please Note: Effective October 1st, 2021, CMS will restart Medicare revalidations for providers and supplies. Prior to this, revalidations were put on hold due to the COVID health emergency.  To determine if you have an pending or upcoming provider revalidation you can utilize Medicare’s Revalidation List online. medicare revalidation lookup.

Although Medicare has put a temporary hold on revalidating their enrolled providers due to the pandemic, this doesn’t mean you can sit back and wait for the suspension to be lifted. With COVID waning, it’s only a matter of time before Medicare revalidation deadlines are active once again. Medicare revalidation lookup.

It is essential that you know how to calculate, find and plan for your Medicare revalidation deadline. Medicare has established an online tool to aid in the process. Missing this deadline can delay your reimbursements, or worse, lead you to be excluded as an approved Medicare provider (and halt your payments). It’s imperative you prepare now.

Calculate Your Revalidation Deadline Medicare revalidation lookup

Your ability to calculate and plan for your Medicare revalidation due date significantly reduces the chance of missing your mandated deadline (and the consequences associated with it). Sure, the Agency gives you plenty of notice before your revalidation is due, but if you miss your email notification, you could easily miss your deadline and be dropped as a Medicare provider. Medicare revalidation lookup.

Medicare utilizes two cycles to manage its revalidations:

  • Providers are on a five-year schedule
  • Suppliers of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) are on a three-year schedule

You can calculate your revalidation deadline based on the date of your provider’s initial Medicare enrollment or their last successful revalidation – whichever is more recent. If your provider hasn’t yet had a revalidation, their first one will be due five years after their initial enrollment on the same date. If you have processed a revalidation, the next one will be due on the same date in another five years.

In addition to calculating your revalidation deadline, there are two additional timelines you should be aware of:

  1. Posting Date: Once you’ve made it to Medicare’s Provider Enrollment, Chain, and Ownership System (PECOS) by the due date, you are required to finalize your revalidation by the last day of the month of your mandated deadline. For example, if you have a September 10th revalidation deadline, you must complete and submit your information by the 30th of that month.
  2. Notification Timing: To give you a little breathing space, CMS posts due dates online six to seven months in advance. Previously, you had to submit your provider’s revalidation within 60 days of the date on the revalidation letter from the Medicare Administrative Contractor (MAC). Now, the MAC sends revalidation notices 90 to 105 days before a revalidation due date. Even though the notices come early, it is still possible to miss them.

Tracking Medicare revalidation deadlines for one provider can be difficult but tracking multiple providers can be a real challenge. To help with this process, you can download this free Excel® credentialing tracking sheet.

Medicare Revalidation List Online Tool Medicare revalidation lookup

To help streamline your revalidation deadlines, you can also utilize CMS’ Medicare Revalidation List. This site provides you with several easy methods to search and manage your provider revalidation deadlines.

When you first arrive at the site, you’ll notice a reverse blue box at the top. This box provides you with several bits of important information, that are constantly changing. Currently, it includes information about revalidation cycles. Note: due date of “TBD” means that the Agency has not set the due date yet.

The next section on the site is “Find a Provider.” This section gives you multiple search options, including:

  • Your practice’s name
  • Your providers’ first and last names
  • Group records and reassigned members
  • National Provider Identifier (NPI) – a unique 10-digit ID number issued to providers by CMS
  • Location: Here you’ll find a drop-down box that allows you to choose your state
    • As a subset to the “Location” search, you can choose “All records,” “Only records with due dates,” or “Records with due dates in the specific range”

Once you’ve specified your search options, click the yellow “Find Provider” button to get your results.

Further down the page, below the search options, you’ll see several additional sections:

  • Access Data: The dark blue reverse button below the “Access data” header allows you to download the full dataset in a condensed zip file. You must extract the information from the zip file to view it.
  • About the Tool: The information in this section changes regularly – verify that you have the most recent information. Currently, you’ll find a blurb about the temporary hold on revalidations due to the pandemic, data refresh date information, a “TBD” status update, information about reassignments, PA employment relationships and DME suppliers.
  • Viewing/Grouping your Data: It may be easier for you to download the data based on how you want to look at it. The options currently available are:
    • Group practice members broke down into alphabetic groups (A-D; E-L; M-R; S-Z)
    • Search the complete list of providers and suppliers
    • Reassignments and PA employment relationships

IMPORTANT: The Medicare Revalidation List tool will continue to show the due date even after the revalidation has been completed or the due date has passed unless your provider has been deactivated or terminated.

Calculating, finding and planning your Medicare revalidation due dates is only the beginning of the process. You must also complete, update and post information based on the site requirements. There’s a lot of ground to cover. That’s where nationally certified credentialing expert, Yesenia Servin, CPMSM, PESC, can help. During her 90-minute online training, Comply with Medicare Provider Revalidation Rules Every Time, she’ll walk you through every aspect of your Medicare provider revalidations to ensure they are done correctly. Every time. Sign up for this training today!

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