Medicare Application Tips For Medical Care Providers
The Medicare Program is a health insurance program of the
U.S. Government. U.S. citizens and permanent residents are eligible for
Medicare coverage if they (or their spouses) worked 10 years or more in
employment covered by Medicare and are at least 65 years old.
Additionally, persons less than 65 years old can be covered by Medicare
benefits if they are disabled or have end-stage renal disease requiring
either kidney dialysis or a transplant.
Before Medicare patients can be accepted by a health
care provider, however, it is necessary for the provider to submit a
Medicare application.
Below are some tips for a health care provider to get faster
approval of its Medicare application.
Medicare coverage and information is subject to change without
notice. Always check with your local Medicare professional for the
most recent information.
1. Obtain A National Provider Identifier (NPI) Before Applying
Health providers must supply a valid NPI on the Medicare
application.
2. Health Providers and Suppliers Should Submit The Most Recent
Version
The Centers for Medicare & Medicaid Services (CMS) revised the CMS-
855 Medicare enrollment applications starting May 1, 2006. Health
care providers must complete that version of the form at the time of
this writing. The Medicare application version is located in the
lower left-hand corner of the form.
3. Health Providers and Suppliers Should Submit The Proper Form Type
The Medicare application form differs for each type of health care
provider. For example, a doctor's office, ambulance provider, and
mental health care institution would each submit a different version
of the form. Each provider's form lists the types of providers that
can utilize it.
4. Include All Supporting Documentation
All requested records must accompany the completed Medicare
application. These records may include professional and business
licenses, identification numbers, and other professional documents.
5. Make Sure Your Application Is Complete
Submitting an incomplete Medicare application requires the agency to
either contact you for the missing information, or return the form
for completion. Save time by supplying all information the first
time.
6. Health Providers and Suppliers Should Submit To The Proper Place
Different contractors process the Medicare application from
different parts of the country. Submitting the completed form to the
wrong address will delay the enrollment.
7. Include All Application Fees If Required
Certain institutions must include a Medicare application fee. The
provider must include all information to pay this fee via electronic
transfer.
8. The Responsible Official Must Sign And Date The Form
The Medicare application process for providers can sometimes be
difficult, so failure to sign and date the form is a common mistake.
9. Handle Medicare Application Information Requests Promptly
The contractor handling a provider's form may have questions. Prompt
responses can keep the application process going.
Most health care providers can get their Medicare application
approved faster if they follow a careful and methodical approach to
completing the enrollment form.
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