Get the free CMS 855I MEDICARE ENROLLMENT APPLICATION PHYSICIANS AND NON PHYSICIAN PRACTITIONERS ...

RCS: IRON: OMB: Page 1. BMS 855I×b MEDICARE ENROLLMENT APPLICATION BR PHYSICIANS AND NON PHYSICIAN PRACTITIONERS (FEDERAL FORMS×.

How to fill out cms 855i medicare enrollment

How to fill out cms 855i Medicare Enrollment:

1. Begin by accessing the official CMS website or contacting your Medicare Administrative Contractor (MAC) for the CMS 855i form. The form can be found online, and a printable version is available for completion.
2. Carefully read the instructions provided with the CMS 855i form before starting. Make sure you have all the necessary information and documents required to fill out the form accurately.
3. Start by entering your personal information, such as your name, address, phone number, and Social Security number. Provide accurate details to avoid any processing delays or complications.
4. Indicate whether you are submitting the CMS 855i for initial enrollment, revalidation, or making any changes to your existing Medicare enrollment. Be specific about the reason for filling out the form.
5. If applicable, provide information about your business or practice, such as the name, address, phone number, and NPI (National Provider Identifier) number. Ensure that all details are correct and up to date.
6. Specify the type of Medicare program you are enrolling in or making changes to. This could include Medicare Part A (institutional providers), Part B (professional providers), or both.
7. Follow the instructions for each section of the form, providing accurate details about your specialty, services, and certifications. Include all relevant attachments and supporting documents, such as licensure, certifications, and accreditations.
8. Complete any additional sections required for your specific enrollment, such as Medicare Part D (prescription drug program) or ordering and referring providers.
9. Review the completed form thoroughly for any errors or omissions. Ensure that all required fields have been filled out and all supporting documentation is attached.
10. Sign and date the completed form, certifying the accuracy of the information provided. If applicable, include additional signatures from authorized officials, such as the authorized official for billing, managing or supervising the provider or supplier.

Who needs cms 855i Medicare Enrollment:

1. Healthcare providers and suppliers who wish to enroll in the Medicare program for billing purposes need to complete the CMS 855i form.
2. Physicians, non-physician practitioners, clinical social workers, clinical psychologists, registered dietitians, and other healthcare professionals who provide medical services to Medicare beneficiaries are required to fill out the CMS 855i form.
3. Those who wish to apply for revalidation of their existing Medicare enrollment or make changes to their current enrollment details also need to complete the CMS 855i form.

It is crucial to carefully follow the instructions and provide accurate information when filling out the CMS 855i Medicare Enrollment form. This ensures a smooth enrollment process and compliance with Medicare regulations.

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What is cms 855i medicare enrollment?

CMS-855i is the Medicare enrollment application for physicians and non-physician practitioners.

Who is required to file cms 855i medicare enrollment?

Physicians and non-physician practitioners who want to enroll in the Medicare program are required to file CMS-855i.

How to fill out cms 855i medicare enrollment?

The CMS-855i can be filled out online or by mail. Applicants must provide all required information and supporting documents.

What is the purpose of cms 855i medicare enrollment?

The purpose of CMS-855i is to enroll healthcare providers in the Medicare program so they can provide services to Medicare beneficiaries.

What information must be reported on cms 855i medicare enrollment?

Information such as personal details, practice location, professional credentials, and any previous Medicare enrollment information must be reported on CMS-855i.