Medicare & Medicaid Provider Enrollment
Medicare & Medicaid
Provider Enrollment
Presented by Zabeen Chong, Director Provider Enrollment & Oversight Group Center for Medicare & Medicaid Services
Charles Schalm, Deputy Director Provider Enrollment & Oversight Group Center for Medicare & Medicaid Services
Session Overview
? How Enrollment Works ? Medicare Policy Updates ? Medicaid Enrollment ? Revalidation ? Our Enrollment Systems ? Protecting the Program ? Enforcement Actions
2
First thoughts
1
2
3
Listening to you
Finding a balance
We hear you, and we've learned a lot from you.
We believe enrollment should be easy for most providers, and hard for bad actors.
Always improving
We will keep refining our systems, policies, transparency, and our vision.
3
How enrollment works
4
How enrollment works
Submission
1
Intake
2
Processing, Screening & Verification
Submit to MAC
855Form 60 days*
? MAC mail room
? Manual data entry
3
PECOS
Medicare
Online
Providers &
45 days*
Suppliers (w/NPI)
Direct Input
4
Finalization & Claims Update
Update claim system MAC updates claim
system (1-2 days)
Provider not approved 6 until claims updated
MAC Recommendation to State /RO Certified providers/suppliers MAC recommends to RO RO performs in 3-9 mo
5
Development Letter
* If the app is complete, and no site visit
Pre Screening signed + dated app fee (or waiver) supporting docs all data elements
5
Verification
Name / LBN SSN / DOB NPPES Address License Adverse Actions
Risk Based Fingerprints Site Visits
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- by langston hughes 1938
- mcgraw hill connect frequently asked questions
- frequently asked questions i already served jury duty in
- never miss a due date again igfoa
- out of the dust
- ellen g white and time setting a warning
- tila respa integrated disclosure rule frequently
- frequently asked questions about garnishments judgments
- tdap td vaccines addressing common questions about
- medicare medicaid provider enrollment
Related searches
- meridian illinois medicaid provider portal
- aarp medicare supplement provider number
- aarp medicare supplement provider portal
- wyoming medicaid provider enrollment
- meridian medicaid provider portal
- aarp medicare complete provider list
- texas medicaid provider services
- wyoming medicaid provider portal
- medicare advantage provider requirements
- medicare dme provider list
- medicare part b enrollment form
- medical assistance provider enrollment pa