CAP@YourService – November/December
Are you watching your mailbox? Between September 2011 and March 23, 2015, the Centers for Medicare & Medicaid Services (CMS) is mailing Medicare revalidation notices to 1.4 million health professionals under new risk screening criteria required by the Affordable Care Act.
Once notified, you will have just 60 days to revalidate your Medicare enrollment. Miss the deadline and your practice could lose its Medicare billing privileges.
CMS has reevaluated the revalidation requirement in the Affordable Care Act and believes it affords the flexibility to extend the revalidation period for another two years. This will allow for a smoother process for providers and contractors. Revalidation notices will now be sent through March of 2015. IMPORTANT: This does not affect those providers that have already received a revalidation notice. If you have received a revalidation notice from your contractor, respond to the request by completing the application either through Internet-based Provider Enrollment, Chain and Ownership System (PECOS) or completing the appropriate 855 application form.
The first set of revalidation notices went to providers who are billing, but are not currently in PECOS. To identify these providers, contractors searched their local systems and if a Provider Transaction Access Number (PTAN) for a physician was not in PECOS, a revalidation request for that physician was sent. CMS asks all providers who receive a request for revalidation to respond to that request.
For providers not in PECOS, CMS will send the revalidation letter to the special payments or primary practice address because it does not have a correspondence address. For providers in PECOS, CMS will send the revalidation letter to the special payments and correspondence addresses simultaneously; if these are the same, it will also be mailed to the primary practice address.
In response to provider requests, CMS has posted a listing of providers who have been sent a request to revalidate their Medicare enrollment information. The listing contains the name and national provider identifier (NPI) of each provider sent a letter, as well as the date the letter was sent. To see the listing, click on “Revalidation Phase 1 Listing” in the Downloads section of the Medicare Provider Supplier Enrollment Revalidation page. NOTE: You must widen each column in the spreadsheet to view the contents. CMS will be updating this list monthly.
If you are listed, and have not received the request, please contact your Medicare contractor. Their toll free number may be found at Medicare Fee-For-Service Contact Information.
Institutional providers (ie, all providers except physicians, nonphysicians practitioners, physician group practices and nonphysician practitioner group practices) must submit the application fee with their revalidation. In mid-September, CMS revised the revalidation letter that contractors sent to providers to clarify who must pay the fee.
For more information on revalidation of Medicare provider enrollment, see MLN article 1126, Further Details on the Revalidation of Provider Enrollment Information.