Completing the revalidation process
Introduction
Revalidation is a complete and thorough re-verification of the information contained in your Medicare enrollment record to ensure it is still accurate and compliant with Medicare regulations. Simply put, revalidation is re-enrollment. All providers and suppliers are required to revalidate their enrollment information every five years.
First Coast must receive your enrollment application within 60 days of the revalidation request.
Revalidate in a few simple steps
- Determine which provider is being requested to revalidate
- View the information checklist
- Revalidate using internet-based PECOS or by completing the appropriate CMS-855 application
- Support resources
- Check your application status
1. Determine which provider is being requested to revalidate
Use the revalidation letter tab within the application status tool to confirm if you have been sent a request to revalidate and to which provider the request applies.
Another option would be to search the revalidation list on CMS
Note: Within the CMS tool, providers due for revalidation will be presented a revalidation due date; all those not up for revalidation will display "TBD" in the due date field. The due date will be posted up to six months in advance to provide sufficient time for the provider to comply. A crosswalk to the organizations to which the individual provider reassigns benefits will also be available.
2. View the checklist for required information for revalidation
Take advantage of this helpful checklist to ensure that you have the information you need to successfully complete your revalidation:
Revalidation application -- required information checklist
3. Revalidate using internet-based PECOS or CMS-855 paper applications
Revalidation primarily consists of completing an enrollment application as you did when you first enrolled in Medicare. The process was developed to confirm the accuracy of your Medicare enrollment record currently on file.
Internet-based PECOS
Expedite the revalidation process by using internet-based PECOS. This online process is the easiest way to revalidate.
- If you are not a registered user – get started with internet-based PECOS today.
Need assistance with the revalidation process using internet-based PECOS? View step-by-step tutorials to walk you through.
Individual physician and non-physician practitioner
Provider/supplier organization requirements
Paper enrollment applications
If you choose to revalidate using paper applications, you must complete all applicable sections of the appropriate CMS-855 form.
Note: Section 1 of each enrollment application includes a checkbox for revalidating your Medicare enrollment and advises which sections of the form are required for completion. Keep in mind this is a thorough re-verification process and most, if not all sections, will be required.
- CMS 855A for Institutional Providers: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/cms855a.pdf
- CMS 855B for Clinics/Group practices and Certain Other Suppliers: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/cms855b.pdf
- CMS 855I for Physicians and Non-Physician Practitioners: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/cms855i.pdf
- CMS 855S for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers: Please visit CGS Medicare, the DMEPOS Medicare Administrative Contractor (MAC) for Florida, Puerto Rico, and the U.S. Virgin Islands.
Unsure which CMS-855 form to complete? Learn more here.
Additional application details
When returning your revalidation application or PECOS web certification and supporting documentation; please use the revalidation project coversheet enclosed with your initial revalidation request letter.
You may either:
Mail completed paper provider / supplier applications to:
JN Provider Enrollment
P.O. Box 3409
Mechanicsburg, PA 17055-1849
Or submit your application via the Provider Enrollment Gateway
- Find additional Application Fee Information
4. Support resources
View the following resources for further assistance with the revalidation process:
- Provider enrollment FAQs – View this list of FAQs for guidance. Locate additional information on the revalidation effort
- Need additional assistance? Contact provider enrollment
- View a sample revalidation letter.
5. Check application status
Use the enrollment status lookup tool to check the status of revalidation applications. This tool may be used for both internet-based PECOS submissions and paper applications.
In addition, providers and suppliers may use the PECOS Self-Service Application to view the status of an internet-based PECOS enrollment application.
- Individual practitioner -- required information includes: First and last names, TIN/TIN type, and NPI.
- Organization -- required information includes: Legal business name, TIN/TIN type, and enrollment state/territory.