Tips on Maintaining Medicare Billing Privileges

The process of enrolling in Medicare has become increasingly complex.  Whether you are renewing your application or submitting an initial application, the consequences of not adhering to the guidelines can be severe.  The following are tips to help maintain your Medicare billing privileges.

First, be sure to notify CMS within 30 days of changing any of your practice locations.  This requirement can often be overlooked when changing a satellite location.  If CMS shows up for an unannounced audit and discovers that your location has changed, you could lose your billing privileges.  Also, if your practice relocates or opens up a location in a new state, check to see if it is in the same Medicare jurisdiction.  If your new location is not in the same jurisdiction, you may have to re-start the enrollment process.

Second, notify CMS whenever a physician leaves your practice.  This can be done by filing Form CMS-855R.

Finally, make sure your Medicare enrollment form is correct on the initial submission.  If there are any complications with the application, it can prolong the effective date.  Medicare only allows you to “back bill” 30 days, so any delay in the effective date can limit your ability to charge for previously performed services.

© 2012 Parsonage Vandenack Williams LLC

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