Medicare Provider Number Application Tips
The Medicare Program is a health insurance program of the U.S. Government. U.S. citizens and permanent residents are eligible for Medicare coverage if they (or their spouses) worked 10 years or more in employment covered by Medicare and are at least 65 years old.
Additionally, persons less than 65 years old can be covered by Medicare benefits if they are disabled or have end-stage renal disease requiring either kidney dialysis or a transplant.
Before Medicare patients can be accepted by a health care provider, however, it is necessary for the provider to submit a Medicare application.
Below are some tips for a health care provider to get faster approval of its Medicare application.
Medicare coverage and information is subject to change without notice. Always check with your local Medicare professional for the most recent information.
1. Obtain A National Provider Identifier (NPI) Before Applying
Health providers must supply a valid NPI on the Medicare application.
2. Health Providers and Suppliers Should Submit The Most Recent Version
The Centers for Medicare & Medicaid Services (CMS) revised the CMS-
855 Medicare enrollment applications starting May 1, 2006. Health care providers must complete that version of the form at the time of this writing. The Medicare application version is located in the lower left-hand corner of the form.
3. Health Providers and Suppliers Should Submit The Proper Form Type
The Medicare application form differs for each type of health care provider. For example, a doctor's office, ambulance provider, and mental health care institution would each submit a different version of the form. Each provider's form lists the types of providers that can utilize it.
4. Include All Supporting Documentation
All requested records must accompany the completed Medicare application. These records may include professional and business licenses, identification numbers, and other professional documents.
5. Make Sure Your Application Is Complete
Submitting an incomplete Medicare application requires the agency to either contact you for the missing information, or return the form for completion. Save time by supplying all information the first time.
6. Health Providers and Suppliers Should Submit To The Proper Place
Different contractors process the Medicare application from different parts of the country. Submitting the completed form to the wrong address will delay the enrollment.
7. Include All Application Fees If Required
Certain institutions must include a Medicare application fee. The provider must include all information to pay this fee via electronic transfer.
8. The Responsible Official Must Sign And Date The Form
The Medicare application process for providers can sometimes be difficult, so failure to sign and date the form is a common mistake.
9. Handle Medicare Application Information Requests Promptly
The contractor handling a provider's form may have questions. Prompt responses can keep the application process going.
Most health care providers can get their Medicare application approved faster if they follow a careful and methodical approach to completing the enrollment form.
Filed under: For Medicare Providers
35 Comments Add your own
1.
GEORGE SO | July 12th, 2007 at 3:17 am
I WAS WONDERING IF YOU CAN PROVIDE INFORMATION REGARDING APPLICATION FOR MEDICARE PROVIDER NUMBER FOR NON-PHYSICIAN CONTRACTORS. WHAT ARE THE REQUIREMENTS? CAN YOU DIRECT TO A WEB SITE THAT MAY HAVE THOSE INFORMATION. THANKS IN ADVANCE.
2.
admin | July 12th, 2007 at 1:33 pm
Hi George,
I think you will find your answer at http://www.cms.hhs.gov/MedicareProviderSupEnroll/.
I hope this helps. Good luck.
3.
steve z | July 26th, 2007 at 3:28 pm
can a pharmacy bill medicare for 1 location to another location if the first location does not have it medicare provider number yet
4.
JUAN C. SANCHEZ | August 10th, 2007 at 9:19 pm
I WANT TO CREATE A HOME HEALTH AIDE IN FLORIDA. WHAT I HAVE TO DO TO OBTAING THE PERMIT OR THE LICENSE?
ALSO, I NEED TO KNOW THE REQUIREMENTS TO DO SO.
THANK YOU VERY MUCH
5.
Joan Lee | August 24th, 2007 at 9:17 pm
I have a Medicare provider number through the company i work for. How do I apply for my own provider number?
6.
Regena R. Stith,LPC | September 24th, 2007 at 7:46 pm
I am a behavioral health provider. I have accessed the tips for application. How/where do I get an application to be a Medicare provider?
7.
Ellouise E Williams | September 27th, 2007 at 2:03 pm
Could you provide information on how to file an aoolication to becime a Medicare provider for mental health services? I am a Licensed Clinical Social Worker. thank you.
8.
Virginia McInturff | October 15th, 2008 at 12:21 pm
Does on need to become a Medicaid Provider to receive reimbursement for transporting someone to medical appointments in Virginia? The patient has both Medicaid and Medicare.
9.
Carolyn Kennedy | November 14th, 2008 at 3:23 pm
I am looking to become a medicaid and medicare provider. I take care of the elderly and special need population. I also offer transportation.
Please advise for the correct process and procedures for obtaining this information
Thanks
10.
Gertrude Oster | February 12th, 2009 at 10:23 pm
How do I apply for my own medicare provider number? I have curently a medicare provider number through my employer.
Thank you for your assistance to this matter.
11.
Alexwebmaster | March 3rd, 2009 at 4:49 am
Hello webmaster
I would like to share with you a link to your site
write me here preonrelt@mail.ru
12.
Nora | April 16th, 2009 at 10:53 am
I need the phone number of Medicare and Medicaid.
Thank You
13.
rick | May 1st, 2009 at 5:33 pm
if i have a medicare provider number in one state, and operate a business in another state providing medical supply equipment, do i need another provider number for that state? or can i bill using the provider number from the other state? or is there a national provider number i must obtain?
14.
Michelle Goolsby | May 31st, 2009 at 11:47 am
I want to become a Medicaid Provider for non-emergency transportation in Georgia is there a site I can go to apply? What are the steps?
15.
Liz Mikolajewski | June 8th, 2009 at 9:37 am
If my provider is applying for a new Medicare number since she going from a independant owner to a PLLC, what is the timeline on the new Medicare number?
16.
Jerry Ann John | June 12th, 2009 at 9:44 am
I would like to apply for a provider number. I am opening a group home for adplescents with emotional problems 6-17 years in Pasadena, Tx. I am a Behavior health provider.
17.
Jeff | June 15th, 2009 at 12:12 pm
How do I get the NPI number for application for medicare provider. Thanks.
18.
Tim O'Brien | June 17th, 2009 at 10:34 am
Seeking info on optaining Medicare Provider Number ? Information for an IOP
19.
Kate Rogers ABM, GCFP, | July 6th, 2009 at 12:00 pm
A client wants me to obtain a Medicare provider number.
A) The phone number they supplied me is not for my area. Could you provide me with a contact number for the (734) area code?
B) Do you supply provider numbers to the “alternative health” field. I am a practitioner of the Anat Baniel and the Feldenkrais Methods; two related organizations who train practitioners in movement re-education and neuromuscular re-education.
Thank you, Kate
20.
wayne blevins | July 7th, 2009 at 2:46 pm
I have a medicare number…..I am now working for a new group…my former office is closed and of course void of perosnell. How can I retrive my current number from the medicare center?
Thank you
21.
irina | December 9th, 2009 at 10:37 am
hi, i have a question, we are trying to obtain a provider number for our organization–we have an ocupational therapist that does art therapy with seniors that need it, and i am having such a hard time finding which form i need to fill out, its either 855 I or 855B, can you suggest anything, –thanks a million in advance, i really need your help!
trying to call on the phone has been exhausting, always on hold can never get a rep. on teh phone, please help!
22.
Peggie Calkins | December 11th, 2009 at 10:09 am
Please advise the process for billing Medicare for flu shots by a fire department, ALS program.
Thank you.
23.
Michael | December 17th, 2009 at 9:02 am
I submitted my 855s application Aug 19 2009, and i still dont have a provider number yet. I was wondering how long does the process take. NSC stated the process takes about 45 days, My on site visit was Sept 10. How long is the process? Thanks Michael
24.
Nancy Aldrich, LCSW | December 20th, 2009 at 10:42 pm
My provider status lapsed several years ago because I had not billed frequently enough. My understanding is that I need to file as a new applicant and since November is past on a new form, not the 8551 I have. I cannot access the new form on line. Can you please help by e-mailing it to me. It would also help to have a phone number for assistance such as was provided in past years.
25.
ericka | January 18th, 2010 at 2:11 pm
I just applied for a medicare number.How long will it take for me to wait for my medicare number? thank you
26.
Dianna | January 21st, 2010 at 5:08 pm
I have a residential Home for 5 seniors i want to apply for a Medicaid provider number so that I can put consumers in residential Homes as well as mine. How can I find out the information? How can I become a waiver agent?
27.
Jackie | January 25th, 2010 at 11:31 am
I want to start an assisted facility in my home what steps so I need to take to make this happen?
28.
Hong Thi Lossing | March 13th, 2010 at 7:23 pm
I worked for an Orhtopaedics Doctor, who applied for Medicare Provider Number since Sept. 2009. Until today, she has not receive any answer back from Medicare yet.
Can you explain to me why?
29.
Linda Lederer | April 13th, 2010 at 4:15 pm
I am an Occupational Therapist and am thinking of opening a private outpatient practice in Illinois with another Occupational Therapist. We want information on what we need to do to obtain a medicare provider number. We would visit medicare patients’ in their homes rather than they coming to our office. If we have an office that will serve non-medicare patients, do we need an office that is wheelchair accessible (without any architectural barriers) with regard to the entrance and bathroom in order to qualify for a medicare number?
30.
Anne Moss | April 13th, 2010 at 11:13 pm
A go between company had me fill out an application for a medicaid provider number (I am a R.N.) and they received it but will not release it until I pay them $50. This is in New York. Is there a number I can call directly to find out what it is.
31.
gilbert bocanegra | April 20th, 2010 at 9:00 am
i have heard that medicare requires that you have around 100,000dollars in the bank before being approved as a new home health care agency in texas. can you verify
32.
fannie | April 21st, 2010 at 9:13 am
I AM INTERESTED IN RECIEVING A MEDICARE PROVIDER NUMBER AND I AM AWARE THAT IN ORDER TO PLACE AN APPLICATION FOR MEDICARE PROVIDER, I NEED TO HAVE A NPI NUMBER . CAN YOU DIRECT ME ON THE STEPS THAT NEED TO BE TAKEN TO AQUIRE THE TWO
33.
Chris St Michel | April 27th, 2010 at 2:58 pm
how do I find out my NPI, medicare and medicaid provider numbers if I misplaced my paperwork?
Thanks
34.
brenda clement | April 27th, 2010 at 4:28 pm
Need information on how to obtain a providers number
for my hhc business for the elderly.and how that process works.
35.
Radha Krishna | May 16th, 2010 at 7:56 pm
I am currently working as a Regestered echocardiographer and registered vascular specialist and general sonographer.How can i get an health care provider number.I would like to start my own business so that i can directly make billing to medicare.Please let me know the procedure .thanks
Leave a Comment
Some HTML allowed:
<a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>
Trackback this post | Subscribe to the comments via RSS Feed