Breaking Down the 2023 Medicare 855 Enrollment Form Updates
Enrolling with Medicare as a provider or organization can be a challenging and time-consuming task. Despite being the largest insurer in the country, the complexities surrounding enrollment application requirements have resulted in a decline in the number of new Medicare enrollment applications. The consequences of incorrect submissions can be severe and have systemic implications, such as delays in cash flow, credentialing issues, coding problems, denial management issues, lower patient satisfaction, and even affect quality scores. In our informative webinar, we will explore the various options available for submitting the 2023 Medicare 855 Enrollment forms, the providers who are eligible for Medicare enrollment, the different form types, and the strategies for navigating the form sections. We will also delve into key terminology, the ancillary documentation required with enrollment submission, applicable fees, the most common errors, and best practices for completing the CMS 855 forms. This webinar aims to equip you with the knowledge and tools needed to successfully complete the Medicare enrollment process and avoid potential pitfalls that can have a significant impact on your organization. Register Now, https://conferencepanel.com/conference/navigating-the-2023-medicare-855-enrollment-form-updates
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Breaking Down the 2023 Medicare 855 Enrollment Form Updates
- 1. Navigating the 2023 CMS 855 Form Updates PRESENTED BY: TONI ELHOMS, CCS, CPC, CPMA, CRC, AHIMA-APPROVED ICD-10-CM / PCS TRAINER
- 2. Toni Elhoms, CCS, CRC, CPC, CPMA, AHIMA Approved ICD-10-CM/PCS Trainer ❑ CEO – Alpha Coding Experts ❑ Podcast Host – Alpha Coding Podcast ❑ National Speaker - Coding, Compliance and Reimbursement SME ❑ Former President of Orlando, FL AAPC Chapter ❑ Expert Witness ❑ Published Author ❑ Consultant/Educator/Trainer
- 3. Agenda Discuss 2023 CMS-855 Form Updates Outline supporting documentation required with enrollment submission Discuss common challenges with form submissions Best Practice Tips Compliance Considerations Q&A at the end
- 4. 2023 Key Enrollment Updates ❑ The new PECOS 2.0 portal is coming in June 2023 ❑ Consolidated Applications ❑ Pre-Populated Entries ❑ Tailored Application Process ❑ Streamlined Revalidation ❑ Rapid Processing ❑ Real-Time Status Tracking ❑ DMEPOS Suppliers must now go through DMEPOS East and West Contractors for Enrollment/Revalidations ❑ National Supplier Clearinghouse (NSC) no longer processes enrollment for DMEPOS suppliers
- 5. CMS-855 Form Types 855 A - Institutional providers 855 B - Clinics/group practices and certain other suppliers 855 I - Physicians and non- physician practitioners 855 R - Reassignment of benefits
- 6. Workflow for 855 Updates Gather all provider contact information and credentialing documentation Login/Register for NPPES – National Plan and Provider Enumeration System Provider/Practice NPI – National Provider Identifier Number PECOS - Provider Enrollment, Chain, and Ownership System OR CMS 855 Forms
- 7. Methods for 855 Submission • Submit appropriate paper CMS 855 Form • Mail supplemental docs with paper application CMS 855 Paper Forms • Surrogate or Provider NPPES login • Include supplemental docs as attachments PECOS online portal
- 8. Entity Types Entity Type 1 – Individual Providers – Provider’s SSN Entity Type 2 – Organizational Providers – EIN of entity
- 9. Most Common Errors Missing Signatures Missing Dates Signatures must be original and signed in BLUE INK Stamped, faxed or copied signatures
- 10. Most Common Errors Person signing the form is not a Delegated or Authorized Party Wrong CMS 855 Form Type Providers / Groups don’t terminate their reassignments Missing Revalidation Deadline because letter went to provider’s home
- 11. Best Practice Tips Attention to detail is imperative and staying organized Have someone else review the forms several times over Include all supporting documentation required Vet your vendors if outsourcing/proper training if insourcing
- 12. Best Practice Tips Information must be accurate and consistent Typed Answers and Live Signatures Respond timely to information requests Don’t miss revalidation deadlines
- 13. Compliance Considerations ❑ Are you using a billing company? ❑ Section 8 ❑ Are you using a credentialing service? ❑ URAC Accredited ❑ Are your NPPs billing incident-to your physicians? ❑ All NPPs need to be enrolled ❑ Do you have specialists or multi-specialty? ❑ Specialty designations ❑ Providers opted out of Medicare or enrolled solely to order, certify, and prescribe do not have to revalidate
- 14. Register Now