Important Reminder: Provider Enrollment Information Change Reporting

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Do you plan on having any significant changes to your practice or health care business in the near future?

If you are a provider or supplier submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries, you must comply with Medicare enrollment change requirements to ensure the continuation of your Medicare billing privileges.

To avoid disruption of your Medicare claims payments, it's essential to report the following changes in your Medicare enrollment information:

  • A change in ownership,
  • An adverse legal action, or
  • A change in practice location.

These enrollment information changes must be reported within 30 days to your MAC via the Provider Enrollment, Chain and Ownership System (PECOS) or, alternatively, by using the CMS 855 paper enrollment application. All other enrollment changes must be reported within 90 days.

This reporting requirement applies to:

  • Physicians
  • Non-physician practitioners - for example, physician assistants, nurse practitioners, clinical nurse specialists, clinical social workers and registered dietitians
  • Physician practitioner organizations
  • Non-physician practitioner organizations

Reporting Requirements for Other Health Care Organizations

Suppliers of durable medical equipment, prosthetics, orthotics and supplies have similar change reporting requirements. Any changes in information supplied on the enrollment application must be reported to the National Supplier Clearinghouse (NSC) within 30 days of the change.

Independent diagnostic testing facilities must report any changes in ownership, location, general supervision and adverse legal actions to your MAC either online or via the CMS-855 form within 30 days of the change. Any other change to enrollment information must be reported within 90 days.

Any provider or supplier not identified in the above categories must report any changes of ownership within 30 days. This includes a change in an authorized or delegated official. Other informational changes are required to be reported within 90 days.

Remember - failure to comply with these reporting requirements may result in the revocation of your Medicare billing privileges!

Let Us Manage All Your Payer Enrollment Services

If you require medical credentialing and payer enrollment needs for your practice or medical facility, please contact 1st Assistant. Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly and will monitor your account for ongoing updates and re-attestations. Heidi Henderson, our company owner and President, is eager to meet you and discuss your payer enrollment needs. Please call us at 512.201.2668 or contact us via the website.