Reporting requirements for a legal business name (LBN) change
When an individual practitioner or a group/organization experience a change to their legal name or LBN, this change should be...
New Medicare enrollment: Which forms do I need to complete?
New to Medicare? Enrollment forms must be completed by all providers of services and suppliers of medical and other health...
What is the purpose of the Medicare Participating Physician or Supplier Agreement (CMS-460)?
New physicians, practitioners, and suppliers may submit the CMS-460 form at the time of their enrollment. Participants agree to accept assignment for all covered services provided to Medicare patients.
Does a physician or non-physician practitioner who has chosen to opt-out of the Medicare program still need to enroll to order/refer items or services for Medicare beneficiaries?
A provider that has opted out of the Medicare program is not required to complete a separate application to order or refer items/services for beneficiaries to other Medicare providers. However, the opt-out provider must meet the following qualifications:
CMS-855 enrollment application processing timeframes
Did you know CMS has defined timeframes for processing CMS-855 forms? Read on to learn more.
What are the requirements for a provider to be eligible to order or refer items or services for a Medicare beneficiary? How can I confirm eligibility as an ordering or referring provider?
According to the CMS change request (CR) 6417 a provider is eligible to order or refer items or services for a Medicare beneficiary only if he or she meets both of the following criteria:
Who should sign the certification statement of the CMS-855 provider enrollment application?
The following shows the information for the various applications:
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CMS-855A and CMS-855B
For initial enrollment and revalidation, the certification statement must be signed and dated (preferably in blue ink) by an authorized official. An authorized official is an appointed official to whom the organization has granted legal authority to enroll it in the Medicare program, make changes or updates to the organization's status, and commit the organization to fully abide by the statutes, regulations, and program instructions of the Medicare program.
Mass immunization roster billers
Read this article if you are a roster biller for mass immunizations or interested in becoming one.
What is the provider’s legal business name that should appear on CMS-855 Medicare enrollment applications?
A provider’s legal business name is the name that is registered with the IRS and should appear on IRS documents, such as the CP-575, that contains a provider’s EIN or TIN.