Yes, again. CMS just released another major wave of revalidation notices. Did any of your providers receive a letter from CMS in a yellow envelope? If so, open it quickly! Failure to respond to these requests by the due date on the letter can result in deactivation of your Medicare enrollment. This means that any practices your providers currently reassign Medicare benefits to will no longer be paid. Fortunately, as of this spring, Medicare has made it easier to find out when your group/providers are due for revalidation. Due dates are now posted on https://data.cms.gov/revalidation – simply plug in your providers and/or group’s NPI. If they’re not due within the next 6 months, they will be listed as “TBD”.
A few things to remember:
- The revalidation requirement does not apply to physicians and non-physician practitioners who have opted out of Medicare.
- The revalidation requirement does not apply to physicians and non-physician practitioners who enroll solely to order and refer (CMS-855O).
When you ‘revalidate’ a provider with CMS, you are re-confirming the information that Medicare has on file for the person. This is the time to clean up any old information in the CMS records. Make sure the correspondence address is correct – you can only list one! Are they really still billing under all those practices they’re currently reassigned to? Many providers move on and their old employers are still ‘kept alive’ in PECOS (the electronic Medicare enrollment system). Group enrollments are subject to revalidations as well. Make sure to confirm the current list of active billing providers and terminate anyone who is no longer affiliated with your practice.
Any provider with a Medicare-enrolled private practice must submit EFT information during the revalidation process. Groups being revalidated also require new EFT set-up. This includes uploading a copy of a bank letter or voided check when completing the revalidation online (or included with paper applications being mailed.) And all non-physicians must submit a copy of their national certification (NCCPA, ANCC). If these documents are not included or if the information submitted is incomplete, Medicare will develop a ‘request for correction’ that gets emailed, mailed or faxed (depending on method of initial application submission) to the contact person on the application. Make sure to respond to the request within 30 days, or your billing privileges will be suspended.
Lastly, if you’re not using PECOS yet for your Medicare applications (new OR revalidations), quit delaying. Make the jump! PECOS has proven to be faster and more efficient than any of the paper applications still being submitted.