The Centers for Medicare and Medicaid Services is always seeking medical providers to see patients. The application process for becoming a Medicare insurance provider is through the Internet-based Medicare Provider Enrollment, Chain and Ownership System (PECOS) or by mail. To receive reimbursement, you must enroll as a Medicare provider before rendering services to Medicare patients. Complete the application carefully to avoid delays in processing. Applying through PECOS is quicker than applying by mail.
Instructions
Online Submission
- Make sure you have a National Plan and Provider Enumeration System (NPPES) user ID and password. PECOS is accessible with your NPPES ID and password. If you need an NPPES ID, call 800-465-3203, visit the NPPES application site (see Resources) or email customerservice@npienumerator.com for assistance.
- Go to the Medicare PECOS website and log in with your NPPES User ID and password.
- Complete the enrollment application online, following the directions on the website. Submit the application. Print the two-page Certification Statement that appears on the PECOS site.
- Sign and date the Certification Statement and gather the required supporting documentation, as instructed on the PECOS site. Mail hard copies of the Certification Statement and supporting documents to your regional Medicare carrier within seven days of the electronic submission. To find your regional Medicare carrier, consult the list on the Centers for Medicare and Medicaid Services' website (see Resources). The carrier must have the signed Certification Statement prior to application review.
- Track your enrollment application's status on the PECOS site. The average application processing time for Internet-based submissions is 45 days.
Mail Submission
- Open the Medicare enrollment application, Form CMS-855, from the Centers for Medicare and Medicaid Services' website. Review which 855 form is appropriate, as there are several based on the type of provider. Individual practitioners use CMS-855I.
- Complete the enrollment application, a PDF document, on your computer or print the PDF to complete by hand. If you wish to complete the PDF on your computer, download the application, save the document to your computer and print it upon completion.
- Mail the application and required supporting documents to your regional Medicare carrier. To find your regional Medicare carrier, consult the list on the Centers for Medicare and Medicaid Services' website (see Resources).
- Wait for written confirmation of your acceptance or denial as a Medicare provider. The average application processing time for paper-based submissions is 60 days.
See also: Average Processing Days for Medicare 855 Application
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