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Last Modified: 12/21/2017 Location: FL, PR, USVI Business: Part A, Part B

Applications with incomplete information

Q: What happens to my application if it is submitted and is found to be incomplete?
A: When an incomplete application is submitted or is missing documents, the provider enrollment specialist will send a letter, send a fax or contact you by telephone outlining the missing information or attachment(s). For missing information on the CMS-855 application, the corrected sections of the application along with a new certification statement must be signed by an authorized official. This information can be faxed back to us since we have your original signature on file. If we are only missing supporting documentation the provider does not need to submit a new certification. You are only required to fax us copies of the missing documentation (e.g., copy of your Internal Revenue Service (IRS) CP-575 form).
Source: The Centers for Medicare & Medicaid Services (CMS) internet-only manual, publication 100-08, chapter 15 external pdf file
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First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.