Medicare Providers Enrollment Application Process Overview

In order for a facility to be able to receive payment for medicare covered procedures, the facility must enroll in the medicare program. The facility must complete the "Medicare Enrollment Application for Institutional Providers" form (CMS-855A). Once the facility decides to enroll in the medicare program, there are several ways that the facility can submit their application.

The facility can request the Provider Enrollment Packet. The packet gives the facility step by step instructions on how to complete and submit the CMS-855A. Facilities can also submit this form electronically by logging onto the Centers for Medicare & Medicaid Services (CMS) Web site. There they can download the form, or submit it electronically.

If the facility is not already a medicare provider and receiving medicare payments directly into their bank account then an electronic funds transfer (EFT) must be submitted with the CMS-855A form. The electronic data interchange (EDI) gives information about submitting funds electronically. This form must be submitted with the CMS-855A in order for the application to be processed.

In addition to the enrollment application, the CMS-855A is required for Change of ownership, stock transfer, additional locations, reactivation of an old medicare provider number, or any other changes in billing or telephone information. This would include address changes, financial information, business name changes, and even changes in management or directing Employees.

A facility that chooses to accept medicare as a form of insurance for patients will receive a National Provider Identifier (NPI). This number must be submitted on all forms so that the review process is quick and efficient. The NPI number should be requested before submitting the CMS-855A forms. Forms without the NPI will not be processed until this step is completed and the NPI is submitted.

Once all the information and application has been submitted, it is then reviewed for approval. Keeping up to date information on file insures that providers receive prompt payment for services rendered under medicare. An audit intermediary (AI) is then assigned to review the CMS-855A form, along with reviewing the medicare providers cost reports to determine final settlement of the cost report. This service helps to provide payment to only viable facilities that are operating in medicare's guide lines and costs.

Medicare is a form of medical insurance issued by the federal government. Payments for services provided under medicare is closely watched to insure that facilities are only billing for services rendered, and that patients are receiving services at the high standard set by medicare. The application process insures that facilities who apply for medicare payments are up to standard and therefor eligible to be a medicare provider.

To Get Answers About the Medicare Provider Application Plus Much More, Visit the Medicare Provider Forums Today at http://medicareforums.org/medicare-provider-discussions-f24/