Updates in Medicare Provider Enrollment Applications

1

• Updates in Medicare Provider Enrollment
  Applications

2
Updates in Medicare Provider Enrollment
Applications

• The Medicare enrollment applications have some
  updates (CMS-855 or Internet-based Provider
  Enrollment, Chain and Ownership System (PECOS))
  is an Office of Management and Budget approved
  forms and are available in PDF fillable formats.
  These formats allow a user to complete an
  application using Adobe Acrobat and save this
  information on their personal computer. Please
  refer to the CMS Forms List link below
• CMS-855A Medicare Enrollment Application for
  Institutional Providers
• CMS-855B Medicare Enrollment Application for
  Clinics, Group Practices, and Certain Other
  Suppliers
• CMS-855I Medicare Enrollment Application for
  Physicians and Non-Physician Practitioners
• CMS-855R Medicare Enrollment Application for
  Reassignment of Medicare Benefits
• CMS-855O Medicare Enrollment Application for
  Eligible Ordering and Referring Physicians and
  Non-physician Practitioners
• CMS-855S Medicare Enrollment Application for
  Durable Medical Equipment, Prosthetics,
  Orthotics, and Supplies (DMEPOS) Suppliers
• CMS-20134 Medicare Enrollment Application for
  Medicare Diabetes Prevention Program (MDPP)
  Suppliers
• All physicians and other qualified healthcare
  experts (as defined in section 1848(k) (3) (B) of
  the Social Security Act) must use the CMS-855I
  (or PECOS) to enroll in the Medicare program and
  receive a Medicare billing number.

Medical Billing Services in Oregon
3
Updates in Medicare Provider Enrollment
Applications
Keep in mind that typed forms are easier for
Medicare to process. But in some cases the most
efficient method for submitting your enrollment
application is to use the Internet Based
Provider Enrollment, Chain and Ownership System
(PECOS). This guides you through the enrollment
application. So, its easy to supply information
relevant to your application. Using
Internet-based PECOS results in a more accurate
application and saves your time and
administrative cost. By submitting a Medicare
enrollment application, a physician provider or
other supplier will establish an enrollment
record in PECOS. For physicians and eligible
non-physician practitioners, this means that your
name and National Provider Identifier (NPI) will
be added to the Ordering and Referring Report
during the next update cycle. Our credentialing
service allows physicians to spend more time with
patients and less time with paperwork. Submit
your medical credentialing documentation to
Medisys just once and we take care of enrolling
you in the networks you choose. We are a group
of medical billing experts who offer
comprehensive billing and coding services to
doctors, physicians hospitals. We provide end
to end billing and coding solutions. Medisys Data
Solutions RCM solutions ensures that the
providers recover every they are entitled to.
Our vision for the providers is You Cure. We
ecure.
Medical Billing Services in Oregon
4
Updates in Medicare Provider Enrollment
Applications

• ADDITIONAL FORMS
• The following forms are routinely submitted with
  an enrollment application
• Electronic Funds Transfer (EFT) Authorization
  Agreement (Form CMS-588)
• Medicare Participating Physician or Supplier
  Agreement (Form CMS-460)
• Source CMS

Medical Billing Services in Oregon