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4 Common Mistakes Not to Make During CMS Medicare Verification Site Visits


Practices and businesses who wish to be enrolled as Medicare providers or suppliers must submit to a site visit as part of the provider enrollment or verification process. The Centers of Medicare & Medicaid Services (CMS) use the information obtained during a site visit to verify that your business is legitimate, and that the information submitted to CMS systems for Medicare enrollment is accurate.

An onsite CMS visit is nothing to be concerned about if your legal health care business is fully compliant with Medicare requirements. Although you still want to dot your i’s and cross your t’s by ensuring your ability to provide services to Medicare beneficiaries are secure.

Below are four common errors to avoid:

  1. Having incorrect information on file for each of your practice locations. Accurate and complete information regarding your location(s) must be on file with your Medicare enrollment contractor. If the CMS auditor can’t find your business that’s a problem.

  2. Failing to make updates regarding changes to your practice. If your address or telephone number changes or you modify the hours of operation, you must inform your Medicare enrollment contractor.

  3. Lack of adequate signage for your practice. CMS site visits take place during posted hours or on Monday through Friday between 9:00 a.m. and 5:00 p.m. If the auditor arrives during the hours shown on your sign and no one is there he can record your business as not operational. The same is true if the auditor is unable to locate your business because the sign is not in plain view or doesn’t clearly show the name of your practice.

  4. Refusing to cooperate with a CMS auditor. Verification and reverification requests may entail the auditor taking photos, interviewing staff and asking questions. Medicare providers and suppliers who don’t fully comply with auditor requests or fail to meet any verification requirements may have their enrollment application denied and/or have Medicare billing privileges revoked.

Let Us Manage All Your Payer Enrollment Services

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.

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