Medicare and Medicaid Revalidation
As part of ongoing payer enrollment for Medicare and Medicaid, health care providers and suppliers must revalidate through the Centers for Medicare & Medicaid Services (CMS).
If you are currently enrolled, you can find your revalidation due date posted on Data.CMS.gov/revalidation, listed up to 6 months in advance. Revalidation applications must be submitted on the last day of the applicable month.
Note that suppliers of Durable Medical Equipment Prosthetic and Orthotic Supplies will receive communications directly from the National Supplier Clearinghouse letting them know when their revalidations are due.
You will be directly notified of the revalidation requirement from your Medicare Administrative Contractor (MAC). This notice will be sent to you within 2-3 months of your revalidation due date and will be sent to the email address reported on your prior applications.
If more than one email address is listed in the contact section of the application, only one will be chosen for the revalidation notice, which may be an issue if the email address chosen is outdated. Without an email address, the notice will be mailed to at least 2 of your reported addresses such as your correspondence and primary practice addresses.
We recommend, if you are within 2 months of your listed due date but have not yet received the MAC revalidation notice, that you go ahead and submit the revalidation application. Note that you should not submit a revalidation if you have not received the MAC notice and your due date is not listed on the database.
The Revalidation Process
You must revalidate your whole enrollment record including all active practice locations and current reassignments. Follow this CMS revalidation checklist for assistance.
The most efficient way to complete your revalidation is via the internet-based PECOS system. Through PECOS you can review your practice's current information, update and submit your revalidation, upload supporting documents and electronically sign your submission.
Alternatively, you can revalidate by submitting your application on paper along with your supporting documentation, and mail the submission. This method, however, will take much long to process than if it is filed electronically through PECOS.
If you don't revalidate by your due date, you risk a possible hold on Medicare payments and deactivation of your Medicare billing privileges. If that occurs, you will have to submit a complete application in order to reactivate your enrollment and once again receive payments.
More revalidation information is available in the CMS Revalidation FAQs.
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.