At 1ˢᵗ Credentialing we know that when our clients place their trust in us, we take that responsibility seriously by communicating with our clients to create a transparent and collaborative partnership.
Healthcare organizations of every size realize that hiring 1ˢᵗ Credentialing is the most economical and efficient way to solve their credentialing needs. We have the training, expertise and commitment it takes to keep a complex process moving forward at all times.
1ˢᵗ Credentialing supports healthcare practices of all sizes - from health systems, to community hospitals, to large group practices, to smaller organizations. We help get your providers up and practicing as fast as possible.
Learning more about the credentialing process benefits us and our clients. 1ˢᵗ Credentialing offers regular videos and newsletter updates to bring our clients and those interested in innovations in credentialing up to speed.
Updated Manual Guidelines for EFT Payments and Change of Ownership
In May of this year, the Centers for Medicare & Medicaid Services (CMS) issued a change request for the purpose of making revisions to the Electric Funds Transfer (EFT) Payments and CHOWs section of the “Medicare Program Integrity Manual.” The revisions explained that after a CHOW has been processed, only the buyer is permitted to submit claims.
A CHOW generally means, in the case of a partnership, the removal, addition or substitution of a partner, unless the partners expressly agree otherwise – and as permitted by the applicable state law.
For corporations, a CHOW generally means the merger of the provider corporation into another corporation, or the consolidation of two or more corporations, resulting in the creation of a new corporation. The transfer of corporate stock or the merger of another corporation into the provider corporation does not constitute change of ownership.
Change of Ownership (CHOW) Example
A common CHOW scenario is when an entity purchases a provider, and the provider’s CMS certification number and provider agreement are transferred to the entity.
For example, suppose that Beach Health Care is enrolled in Medicare but Mountain Health Care is not. If Mountain Health Care acquires Beach Health Care, then Beach Health Care’s provider agreement and certification number will transfer to Mountain Health Care, providing that all regulatory requirements are met. When a new owner accepts the provider agreement, it accepts the terms and conditions under which it was originally issued.
Importantly, old and new owners are responsible for working together on payment arrangements for claims furnished during and before the CHOW is processed. The Medicare Administrative Coordinator (MAC) won’t be able to update the crosswalk in order for the seller to complete their billing.
If you require medical credentialing and payer enrollment needs for your practice or medical facility, please contact 1st Assistant. Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly and will monitor your account for ongoing updates and re-attestations. Heidi Henderson, our company owner and President, is eager to meet you and discuss your payer enrollment needs. Please call us at 512.201.2668 or contact us via the website.
Our credentialing experts are here to help you assess exactly which solutions you need and let you know how inexpensively we could put you on the right track. 1ˢᵗ Credentialing includes primary source verification and payor enrollment for all insurance networks including Medicare, Medicaid, Medi-Cal and insurance networks. Don’t wait another minute, contact our terrific team today!