Medicare Provider Enrollment

What does the Medicare Provider Enrollment process require?

Medicare provider enrollment can be a time consuming process.  The enrollment process involves submitting the appropriate Medicare Provider/Supplier Enrollment forms such as the CMS-855I, CMS-855B, CMS-855S, and CMS-855A.  Alternatively, you can use the Provider Enrollment, Chain, and Ownership System (PECOS) to enter your enrollment application online.  The PECOS system uses your NPI login information to connect to the Medicare Provider Enrollment system.  When a paper provider enrollment form is submitted to a Medicare contractor, the enrollment department keys the paper application into PECOS for processing the application against all the enrollment requirements.

Medicare will typically take 60 days to process enrollment applications for individual providers.  Applications for facilities, DME companies, Home Health agencies, Independent diagnostic testing facilities, and other organizations can take longer due to the stringent enrollment requirements including site visits.  The time frame for application completion varies widely based on the work queue of the contractor.  The Medicare revalidation project is causing many Medicare contractors to be overloaded with work and resulting in longer than normal turnaround times for applications.

There are many service companies who can assist providers and organizations with the Medicare provider enrollment process.  Engaging someone who is familiar with the process can save time and headaches down the road.  Medicare is an important payor for most medical facilities, so be sure to get your enrollment done correctly the first time and make sure that your Medicare provider enrollment records stay up to date.

Visit Medicare’s Provider Enrollment area on their website for more information about becoming a Medicare Provider.