If you want to get your providers credentialed and enrolled in the Medicare program faster, then you’ll need to know your way around the CMS-855I Medicare enrollment application. Completing this for new doctors will allow you to bill for their services and add to your practice’s bottom line.
To navigate the Medicare enrollment form, check out a few features of sections 1-3 of the CMS 855-I that will help you get your application processed faster than ever.
Visit the Training Leader site next week for tips on completing sections 4-17 of the form.
Section 1A: Reason for Submitting the CMS-855I
The very first section of the Medicare enrollment form asks you to check a box indicating your reason for submitting it. While this may seem straightforward, there are a few rules you must know if you want your application processed quickly.
You should check only one reason for completing the application. So if you’re a new Medicare enrollee and you’re enrolling with another Medicare Administrative Contractor (MAC), you wouldn’t check both of those boxes. Instead, you’d only mark that you’re a new Medicare enrollee on this form.
It’s also important to follow the instructions to the right of each check box. For example, if you’re a new Medicare enrollee, you’ll complete all applicable sections. But if you’re reporting a change to your enrollment information, you’ll skip straight to section 1B.
Section 2: Identifying Information
When you’re filling out section 2 of the Medicare enrollment form, make sure you complete all of the personal information in section 2A, and include copies of all licenses or certifications.
When you get to section 2B, you’ll include details of where the applicant (the doctor) can be contacted. Don’t list a billing agency’s address — instead make sure it’s somewhere that the provider will actually receive the correspondence, such as your practice’s address.
In section 2D1, you’ll add the provider’s primary specialty with a “P” and their secondary specialty with an “S.” So if the doctor is primarily a plastic and reconstructive surgeon as well as a general surgeon, you’ll list a “P” next to Plastic and reconstructive surgery and an “S” next to General surgery.
Nonphysician practitioners (NPP) should complete section 2D2, noting only one specialty. If the NPP has multiple specialties, they’ll need to submit separate CMS-855I Medicare enrollment forms for each specialty.
Section 3: Adverse Legal Actions
Some providers skip this section because they haven’t had any adverse legal actions imposed against them, but this is the wrong move. You must complete question 1 no matter what. If you have no legal actions, answer “no” and then skip to section 4. If you have had adverse legal actions, mark “Yes” and fill out the rest of section 3 with details about the adverse legal action.
Your application will be rejected due to being incomplete if you fail to complete this section, so it’s imperative that you fill out section 3.
Check out part two of this series for tips on completing sections 4-17 of the Medicare Enrollment application.
Faster credentialing is possible if you have an expert on your side! Let Yesenia Servin, CPMSM, PESC, walk you through the application during her online training, 855I Medicare Enrollment Form, Master New Changes to Get Paid. Register today!
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