MEDICARE PROVIDER & SUPPLIER ENROLLMENT & REVALIDATION

“Physician practices are anticipating major difficulties with Medicare enrollment rules that went into effect amid protests from doctors and practice managers. A wrong step by a practice could mean that it loses Medicare revenue or even gets kicked out of the program altogether.”

– American Medical News, American Medical Association

PROVIDER & SUPPLIER ENROLLMENT

The Affordable Care Act (ACA) requires health care providers, such as physicians, physician’s assistants, nurse practioners, and others to be enrolled in the Medicare Program before they can order or refer items or services for Medicare beneficiaries. Thus, the Medicare enrollment process is a critical necessity for medical professionals wishing to participate in the program.  More importantly, enrollment is essential for health care providers who wish to receive reimbursement from Medicare.

With the increased number of health care providers enrolling in the Medicare program, enrollment applications are being delayed or rejected if there is any missing information or documentation when submitted to the Medicare contractor.  Since even the slightest mistake can delay the entire process, including delays to the reimbursement for services rendered by health care professionals.  This can negatively impact a provider’s cash flows.  It has been our experience that most physician offices, billing services or other health care suppliers simply do not have the experience or expertise to successfully complete the Medicare enrollment process which can allow for the timely payment of Medicare services rendered.

Gaitan Law Group has a team of qualified professionals handling your Medicare enrollment application, to ensure that your practice application is processed as quickly as possible.  We take care of this critical, tedious and time-consuming process, so that our clients can focus on providing outstanding health care services.  Our firm is also well equipped to appeal any effective date of participation dispute, revocation of billing privileges or participation agreement,  or other enrollment disputes.

Through our physician Medicare enrollment services, Gaitan Law Group will complete, submit and track your Medicare application, whether its an 855B, 855I or 855R; obtain you Medicare provider number (for new Medicare providers); complete Reassignment of benefits; and apply for electronic funds transfer (EFT).

MEDICARE REVALIDATION

The Medicare program requires all enrolled providers and suppliers to revalidate enrollment information every five years, while also permitting the Center for Medicare and Medicaid Services (CMS) to conduct off-cycle revalidations for certain program integrity purposes.

Under the ACA, all physicians enrolled with Medicare prior to March 25, 2011, will be required to revalidate before March, 2015. Upon receipt of the written request to revalidate from the Medicare Enrollment Contractor (MAC), the physician provider only has 60 days — from the post mark date of the letter — to submit complete enrollment information.

Since September, 2011, the CMS MACs have been mailing revalidation notices to Medicare providers, and our experts have been ensuring the continued participation of physician providers in the Medicare program.  Let the professionals at the Health and Business Solutions Group prepare and submit your Medicare revalidation application; and avoid detrimental interruption in Medicare participation and reimbursement.

The health care attorneys at Gaitan Law Group have been counseling Medicare providers and suppliers on enrollment issues for over 40 years.   Our unique understanding of the enrollment process and attention to program requirements has made us the most recognized name among physicians, home health agencies,  assisted   living facilities, skilled nursing facilities, DME suppliers, IDTFs and other Medicare suppliers and providers facing Medicare enrollment such as participation, revalidation and suspension. Through years of experience, we have         learned how to correctly prepare and submit Medicare enrollment and revalidation applications, saving providers and suppliers time and money.

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