Site Visits

Site Visits Site visits may be required for certain providers and will be unannounced; the contractor representatives must disclose to the provider appropriate identifying credentials and explain the purpose of the visit. The CMS has [...]

PECOS Self-Service Application Status

PECOS Self-Service Application Status You may run simple search queries to retrieve and view the status of your PECOS application. Individual ‒ View the enrollment application status of an individual provider in an organization or private [...]

Check Provider Enrollment Application Status

Check Provider Enrollment Application Status You may run simple search queries to retrieve and view the status of your CMS-855 application via two options. Case number/web tracker id NPI and TIN combination Related Content Check [...]

Interactive Voice Response System

Interactive Voice Response System You may check the status of your provider enrollment application (PECOS or paper) submissions via the IVR by: Case number/web tracker id or NPI and TIN combination Related Content Interactive Voice [...]

Approval or Denial

Approval or Denial Approval Once your application is approved, you will receive an emailed, faxed or mailed Medicare letter with PTAN. Review this letter to ensure that everything is accurate and if you have any questions, please contact the [...]

Approval or Denial

Approval or Denial Approval Once your application is approved, you will receive an emailed, faxed or mailed Medicare letter with PTAN. Review this letter to ensure that everything is accurate and if you have any questions, please contact the [...]

Requests for Additional Information

Requests for Additional Information While processing the application(s), National Government Services may determine additional information is needed. All requested information should be submitted as soon as possible, but no later than 30 days [...]

Sign and Submit the Application(s)

Credit Balance Reminder: Submissions For Quarter Ending 6/30/2024 Start Soon!

Credit Balance Reminder: Submissions For Quarter Ending 6/30/2024 Start Soon! CBR submissions can be submitted starting on 7/1/2024 and are due within 30 days to be considered timely. Remember, even if no monies are owed to Medicare for this [...]

Accelerated Payment Program Available for Providers Impacted by the Ascension Health Cyber Related Incident (CRI)

Accelerated Payment Program Available for Providers Impacted by the Ascension Health Cyber Related Incident Part A Providers experiencing cash flow problems related to Ascension Health CRI, which began on 5/8/2024, may be eligible for [...]

PECOS Enrollment Process and Advantages

Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers-Register Today for June 25th Sessions!

Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers-Register Today for June 25th Sessions! We’re wrapping up our Medicare Part B 2024 Spring/Summer Virtual Conference with education [...]

Provider Enrollment

Provider Enrollment The National Government Services Provider Customer Care Department has direct telephone lines available for provider enrollment inquiries. Who should I call for technical issues regarding PECOS, EUS Helpdesk or MAC? CMS [...]

Provider Enrollment

Provider Enrollment The National Government Services Provider Customer Care Department has direct telephone lines available for provider enrollment inquiries. Who should I call for technical issues regarding PECOS, EUS Helpdesk or MAC? CMS [...]

Opt Out and Private Contracting

Opt Out and Private Contracting Opt out does not require a physician or practitioner to initially enroll with Medicare or complete a CMS-855I application. Opting out of Medicare allows a physician or practitioner to render services to [...]

Renewal to the Medicare Opt-Out Law for Physicians and Practitioners

Renewal to the Medicare Opt-Out Law for Physicians and Practitioners Prior to enactment of the MARCA of 2015, physician or practitioner opt-out affidavits were only effective for two years. As a result of changes made by MACRA, valid opt-out [...]

Opt-Out Physician or Practitioner Providing Emergency or Urgent Care

Opt-Out Physician or Practitioner Providing Emergency or Urgent Care In an emergency or urgent situation, a physician or practitioner who opts out may treat a Medicare beneficiary with whom they do not have a private contract. In this [...]

Providers Not Eligible to Opt Out and Enter Into Private Contracts

Providers Not Eligible to Opt Out and Enter Into Private Contracts Providers Who May Not Opt Out of the Medicare Program Chiropractors Opt-out law does not define ‘physician’ to include chiropractors; therefore, they may not opt out of [...]

Instructions to File

Instructions to File The requirements to opting out of Medicare are included on the forms. First, at least one private contracting agreement form must be signed between the physician or practitioner and a beneficiary. Second, the physician [...]

Requirements of Medicare Private Contracting Agreement

Requirements of Medicare Private Contracting Agreement Amendment 4507 of the Balanced Budget Act of 1997 permits a physician or practitioner to “opt out” of Medicare and enter into private contracts with Medicare beneficiaries. Under the [...]