Voluntary terminations
Read this article for instructions on how to terminate your Medicare enrollment.
How do I get a copy of my Medicare certification letter that shows the certification number and effective date?
You can call the JN provider enrollment help desk at 1-888-845-8614 to request a copy of the letter, as long as you're currently listed on the enrollment record. You can also submit a request for a copy of your enrollment certification by sending a request for the information on company letterhead to First Coast’s provider enrollment department. The request needs to be signed by either the authorized official (AO), delegated official (DO) or the practitioner as it is listed on your entity’s enrollment record.
What is the difference between the effective date and retrospective billing date?
The effective date is the later of the following two dates:
- The filing date of an enrollment application that was subsequently approved, or
- The date the provider first began furnishing services at a new practice location.
The provider may bill retrospectively for services when:
How and when will I be notified of the review results?
Upon completion of the service-specific review, a "Post-Payment Service Specific Review Results" letter will be mailed to you detailing the outcome of the review, individual claim review determination(s) and education on the findings. The results letter will also provide contact information for the nurse who reviewed the case to assist with any additional education needs to ensure your understanding of the results, how they were determined and, if applicable, how to improve your Medicare billings.
I am the sole owner of two practice locations. Do I need to submit a CMS-855I or CMS-855B for each location?
Sole owners who are initially enrolling will use the CMS-855I. For practice locations that operate under the same tax identification number (TIN), you will submit only one CMS-855I application; however, you will need to include two Section 4B pages to identify each practice location.
If an enrolled sole owner is adding a new practice location to an existing record, this can be updated on either the CMS-855I or the CMS-855B.
For practice locations that operate under separate TINs, you will need to submit separate applications for each of the practices.
Where do I indicate a rendering physician’s billing number on my claim?
If the practitioner rendering the service is part of a billing group, report the individual practitioner’s NPI in the 'Rendering Physician #' area (2310B loop, segments NM108 [XX] and NM109 [NPI], of the 837P electronic claim or Item 24J of the CMS-1500 paper claim form).
Where can I find an example of a "signature attestation statement"? Is a specific form required?
CMS requires that any Medicare service provided or ordered must be authenticated by the author -- the one who provided or ordered that service. Certain types of signatures (e.g., illegible signatures, initials) may require the addition of a “signature attestation statement” or a signature log to the documentation to ensure the signature’s authentication. If documentation submitted for medical review does not contain a signature at all, then only a signature attestation will be accepted.
The claim for my patient's dates of service (DOS) overlaps a Medicare Advantage plan and hospice elections period. Should I bill the hospice, original Medicare, or the Medicare Advantage plan?
Federal regulations require that MACs maintain payment responsibility for managed care enrollees who elect hospice.
While a hospice election is in effect, certain types of claims may be submitted to the MAC by either the hospice provider or a provider treating an illness not related to the terminal condition. The claims are subject to Medicare rules of payment.
My inpatient claim is overlapping a home health episode with the same date(s) of service. How can I resolve this?
Claims for inpatient hospital and skilled nursing facility (SNF) services have priority over claims for home health services because beneficiaries cannot receive home care while they are institutionalized. A beneficiary cannot be institutionalized and simultaneously receive home care.