Assess Revalidation Efforts in 12 Questions

Medical Office Billing & Collections Alert 2008: Volume 8, Number 6

Start to revise your processes if you're answering 'no.'

1. Is your provider's Medicare correspondence address on file current and reliable? If not, your provider may not receive a revalidation request, which may cause you to miss the filing deadline.

2. Does your practice have processes in place to track pertinent information on new and existing board members and managing employees?

3. Do you actively track all practice locations that you bill as provider-based?

4. Is your practice prepared to submit all required supporting documentation with a complete CMS-855, such as legal formation documents, IRS tax ID confirmations, state licenses, certifications, EFT bank account letters, and NPI confirmations?

5. Do your provider's NPIs accurately reflect applicable provider numbers and taxonomy codes, legal business names, etc.?

6. Has your provider filed a complete CMS-855 in the last 12 months? If so, you may be exempt from the revalidation process.

7. When you submit a revalidation application, does the application accurately reflect all practice locations?

8. Are Section 5's included for all organizational owners and managers, including chain home offices?

9. Are Section 6's included for all board members and at least one W-2 managing employee?

10. Do you retain copies of all Medicare enrollment applications, including initial enrollments, changes of ownership, changes of information, and revalidations?

11. Do you file CMS-855 changes of information within 90 days of all changes to practice locations, board members, managing employees, owners, authorized officials, and delegated officials?

12. Do you have a CMS-issued provider-based determination for each practice location listed in the 855 (if applicable)?

Source: This list of questions is adapted from a list provided by Murer Consultants Inc.