Effective March 25, 2011, Medicare has made the following changes in the provider enrollment process:
- Provider enrollment screening categories have been established. Based upon the type of provider/supplier, CMS will classify enrollment as Limited, Moderate or High. The risk levels denote the level of the contractor?s screening of the provider or supplier when it initially enrolls in Medicare, adds a new practice location, or revalidates its enrollment information. Most physicians and hospitals will fall within the Limited category. New screening categories and definitions are detailed in the reference guide link below.
- An application/revalidation fee is now due from institutional providers/suppliers. The CY 2011 application fee is $505.00. Payments must be made via www.pay.gov. Payment must be received by CMS in order for the application/revalidation to be processed.
Timely submission of provider enrollment applications can have a significant revenue impact specific to the on-boarding of a new physician or other provider. It is critically important that an organization understand the application process and follow through in a timely manner according to the new provider enrollment requirements. To view a quick reference guide summary of Medicare Provider Enrollment Updates in greater detail, including common enrollment scenarios and a listing of CMS resource web addresses, please click here.
Do you have additional questions about the Medicare provider enrollment process? Or other physician practice management questions? Please contact the experts listed below at (800) 270-9629.
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