Avoid Medicare Denials by Notifying Medicare of Any Changes in Your Information

Medicare requires that providers notify them when they make any changes to their office location, tax ID#, legal history, managing employees, or personal information. The notification is suppose to be within 30 days of the change. Many providers do not realize this until their Medicare payments suddenly stop for no apparent reason.

An example would be if a provider changes their office location. Maybe the provider is just moving across the hall in the same building. The only thing that changed is the suite number. Medicare payments can be stopped due to this. If the business address changes any mail from Medicare will be returned to Medicare. When they receive returned mail they stop Medicare payments until they can investigate why.

Another example of changing information is if a provider decides to stop using their social security number and starts using an EIN (employee identification number). They cannot just start billing under the tax ID number. They must notify Medicare. They must also make sure that their billing information matches what is on file under their NPI number.

If any of this information does not match up, Medicare will deny any claims until the information is cleared up. It may mean updating your NPI information or it may mean that you need to complete a Medicare application with your new information.

If you need to change your information with Medicare you will need to submit the change on the appropriate CMS form. To change personal information only or if you are a solo provider without a group number you would use the 855I. If you are making changes to a group, you would use the 855B.

By notifying Medicare of any changes, no matter how small they seem to be you can avoid unnecessary delays in your Medicare payments, and disruptions to your cash flow. It is better to notify Medicare in advance of the change, if at all possible, as it takes Medicare from 2 to 8 weeks to make the changes. But if not in advance, make sure you notify them of changes as soon as possible.

Alice Scott and her daughter / partner Michele Redmond are co-owners of a medical billing service. They offer an informational website for both physician's offices and the general public looking for information or help with their problems with medical insurance billing. Check out their website for more information, more about important changes now going on in Medical Insurance Billing, or to sign up for their free monthly newsletter.