CMS Site Visits – How Would Your Practice Do?

The Centers for Medicare & Medicaid Services (CMS) requires an onsite review of Medicare enrolled providers and suppliers under certain conditions.

The reviews are required to ensure that these healthcare providers actually exist and that they meet the requirements to provide services to Medicare beneficiaries. The onsite visits are integral parts of the enrollment validation process. Generally, the visits are required for moderate to high-risk providers during the initial enrollment, revalidation and when a new location is added.

You can read about the basic requirements for the onsite visits in our earlier blog.

Would Your Practice Pass the Onsite Review?

Even if you are fully compliant with the enrollment rules, you are still at risk of revocation of billing practices if you fail the onsite visit. For example, the site inspector may not be able to locate your business if the outside signage is missing, your enrolled address is wrong or if your practice is not open at the time of the visit. 

Do a pre-visit audit yourself to avoid billing revocation because of a problem at an onsite visit:

  • Check that CMS has complete and current information for each of your locations.
  • Make sure that you have a process in place to report any changes including address, telephone number and hours of operation.
  • Take a look at your signage for accuracy. Make sure hours of operation are clearly posted.
  • Add any necessary information to find your practice if you are located in another facility like a hospital or nursing home, or if your building prohibits signage.
  • Site verification visits are made between 9:00am and 5:00pm. If your office is not regularly open during those hours, make sure your enrollment information includes your hours of operation.

Be proactive in this process! If CMS determines that your practice is not operational, you risk revocation of 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.