Has Your Practice Experienced Changes that Must Be Reported to CMS? 3 Critical Mistakes To Avoid

Once your practice is enrolled in Medicare, don’t just sit back and relax! There are certain business changes that must be reported to the Centers for Medicare & Medicaid Services (CMS) on a timely basis, or your practice risks suspension or losing eligibility for Medicare reimbursements.

Here are the top 3 provider enrollment reporting mistakes that we see here at 1st Assistant:

Not realizing that a change must be reported. A change in ownership, or CHOW, or a change in certain information about a practice must be reported to CMS.  A CHOW can be a merger, a consolidation or a change in partnership members. Examples of a reportable information change include opening or closing a location, moving to a new location, a stock transfer or an adverse legal action.

Not reporting the change by the deadline. There is a relatively short window to report these changes, so act quickly. Physicians and physician organizations, as well as non-physicians and non-physician organizations, have only 30 days to report practice location and ownership changes, as well as any adverse legal actions, to CMS. All other changes to Medicare enrollment information must be made within 90 days. These include changes to corporate officers, billing agency and taxpayer identification number. For most other suppliers and hospitals, report ownership, managerial control or delegated official changes to CMS within 30 days. These organizations have 90 days to report other changes such as adverse legal actions and changes to officers, payment address, taxpayer identification number and billing agency.

Not reporting the change properly. Report change within the required timeframe via the Provider Enrollment, Chain and Ownership System (PECOS).

Remember that failure to report any of these provider changes may cause your Medicare billing privileges to be revoked.

You can read a MLN Matters® publication on this topic here.

Let Us Manage All Your Payer Enrollment and Credentialing 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.