Most providers must go through the Medicare revalidation process every five years, and if you don’t do it correctly, you could seriously harm your ability to collect from Medicare payers. CMS stats indicate that about 30-35% of applications have errors or incomplete data, resulting in delays. If you want to avoid being a statistic, you’ll need to know what the most common errors are so you can avoid them.
Check out three common Medicare revalidation mistakes, along with tips on how you can make sure you don’t make these same errors.
1. Missing the Medicare Revalidation Deadline
A common refrain from practices that miss the revalidation deadline is that they “didn’t get a notice in the mail” to revalidate — but that excuse won’t hold water with your Medicare Administrative Contractor (MAC). Providers and their staff members should be tracking their deadlines since they occur every five years (or every three years for DME providers or suppliers). If you happen to forget when yours is coming, you can search the Medicare Revalidation List to find out when it’s due. CMS will post your revalidation date seven months before it’s due.
If you fear you’re at risk of doing missing a revalidation deadline, you’ll be unable to file for an extension because those don’t exist when it comes to revalidation. If you miss the deadline, you’ll have to submit a complete Medicare enrollment application and wait for your billing privileges to be reactivated. During the interim waiting period, you won’t be reimbursed by Medicare for services performed while you were deactivated.
How to avoid this fate: Assign a staff member to be in charge of revalidation at your practice and ensure that they are tracking the revalidation dates on a shared calendar so everyone has access to it. If you know you’re within three months of your revalidation due date, process the revalidation even if you haven’t received a notification yet. If you do get a revalidation request, prioritize it and process it immediately to avoid losing billing privileges.
2. Revalidating Too Early
Some practices are so nervous about missing the revalidation deadline that they submit a revalidation application far ahead of the deadline — but this is another common mistake. If you submit your revalidation more than seven months from the due date, you’ll get it returned to you without being processed.
How to avoid this fate: Get all of the materials you’ll need for revalidation ahead of time (such as the provider’s Social Security number, license, etc.), but don’t submit it until you’re within the revalidation window.
3. Failing to Submit Additional Requested Information
For most providers, revalidation occurs in one simple step. Unfortunately, there are sometimes incidents when it takes longer. If you’re missing information that your MAC needs to process the revalidation, they may ask for more information, and you’ll have 30 days to submit it. If you miss the 30-day deadline, you could lose your Medicare billing privileges.
How to avoid this fate: Check email, mail and phone communications every day after you submit your revalidation for notifications from your MAC and prioritize them above other responsibilities to ensure you’re on top of everything your payer needs.
Get paid faster with proven Medicare revalidation tips from expert Yesenia Servin, CPMSM, PESC, during her online training, Stop Medicare Revalidation Rejections and Payment Delays Fast. Register today!
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