Tips to avoid deactivation or revocation of your Medicare billing privileges
Please review and share the scenarios below with your enrollment and credentialing staff to avoid possible deactivation or revocation of Medicare billing privileges.
Relocating to a new state
If you are moving and will no longer render services in your current state, it is imperative that you terminate your enrollment in that particular state. By submitting an 855 application, to voluntarily terminate your enrollment record in the state you are leaving, you will avoid having your privileges revoked for license expiration in your current state. Your license and enrollment record status in the old state could ultimately affect new enrollments in different states.
Deceased provider
In the unfortunate circumstance of the death of an associate, Provider Enrollment Services will need to remove the deceased associate from your record. Please submit the appropriate 855 application to terminate the association of your group's deceased partial owner, partner, authorized or delegated official, and/or managing employee. It is imperative that you report this change of information within 90 days to avoid deactivation of your group's billing privileges.
Adverse legal actions imposed on an associate
If adverse legal action has been imposed on someone associated with your group, it is crucial that you report this within 30 days. By submitting an 855 application to terminate the association with that individual, you may potentially avoid revocation of the billing privileges of the associated group.
Reporting accurate practice locations
It is critical that you report the actual physical location of where you render services versus your home address or administrative office. If you are rendering care in nursing homes or hospitals, you must report that actual location even if you do not have personal office space at that facility. If it is determined that you are not reporting the correct location, you may be subject to revocation of billing privileges.