| CREDENTIALING
Frequently Asked Questions
1. How long will it take before I receive a provider billing number?
CMS has established certain time frame standards to ensure that applications are processed in an acceptable amount of time. A provider/supplier who completes the proper form and submits all the needed information will generally receive their number in less than 60 days.
2. What are the different Medicare provider enrollment applications?
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Type of CMS 855 Application
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Situation
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CMS 855B
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Provider groups
- Change of information (including address changes)
- New provider group
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CMS 8551 |
Individual provider
- Change of information (including address changes)
- New individual provider
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CMS 855R |
Individual provider (to assign any payment to the group)
- Joining, leaving or changing groups
- Changing practice address
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3. What does it mean to be a Medicare participating provider?
Having a Medicare Number does not designate you as a participating provider within the Medicare program. A participating provider enters into a separate agreement (CMS-460) with the Medicare program to accept assignment on all Medicare Part B claims. The participant agrees to accept the Medicare-approved amount as full payment for services and supplies covered under Part B.
4. How do I apply for an NPI number?
To apply for an NPI or change information related to an existing NPI, refer to the NPI Enumerator’s web site: https://nppes.cms.hhs.gov/NPPES/Welcome.do or call the Enumerator at 800-465-3203.
5. How do I know if Medicare and NPI registry have correct information?
Access the CMS NPI Registry at http://www.cms.hhs.gov/NationalProvidentStand/06a_DataDissemination.asp. Legacy information on file with Palmetto GBA must match information on file with the NPI Enumerator. To correct discrepancies in NPI information, access the Enumerator web site or call the Enumerator directly at the number listed above. To correct information on file with Palmetto GBA, you must complete the appropriate CMS-855 application.
Information taken from www.PalmettoGBA.com.
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