Why did I recently receive a revalidation request letter?
All new and existing providers enrolled with Medicare prior to March 25, 2011, must revalidate their enrollment information in accordance with the Patient Protection and Affordable Care Act, but only after receiving notification from the MAC. Even if your records were entered into PECOS on March 24, 2011, you are still required to revalidate the information.
Do I have to pay the enrollment application fee of $523 when submitting revalidation application?
All institutional providers and suppliers that are revalidating their enrollment must pay the application fee. You may submit your fee by electronic check, debit or credit card. Revalidations are processed only when fees have cleared.
Physicians, non-physician practitioners, physician group practices and non-physician group practices do not have to pay the application fee unless they are enrolling as a Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) supplier via the CMS-855S application.
How do I pay my application fee?
To pay your application fee on the PECOS website, type ‘CMS’ in the search box under Find Public Forms, and click the Go button.
- Click on the CMS Medicare Application Fee link
- Complete the form and submit payment as directed
- A confirmation screen will display indicating payment was successfully made
- This confirmation screen is your receipt and you should print it for your records
- Palmetto GBA strongly recommends you mail this receipt along with the Certification Statement for the enrollment application
How long do I have to submit the revalidation application?
Upon receipt of the revalidation request, providers and suppliers have 60 days from the date of the letter to submit complete enrollment forms.
What is the outcome if I fail to submit the enrollment forms?
Failure to submit the enrollment forms as requested may result in the deactivation of your Medicare billing privileges.
I have not received a revalidation notification letter; can I submit my revalidation application to the MAC anyway?
All providers should wait until they have received notification from the MAC before submitting a revalidation application.
Do I have to submit an authorization agreement for electronic funds transfer (EFT – CMS Form 588) with my revalidation application?
Providers already receiving reimbursement via EFT should not submit a CMS Form 588 with the revalidation application. If you are not receiving payment via EFT, then an EFT agreement is required.
How can I check to see if my revalidation application has been received by Palmetto GBA?
Please allow up to three weeks and then you may access on our website. You can verify receipt and status of applications with your PTAN number.
What method should I use to submit my revalidation application?
The most efficient way to submit your revalidation information is by using Internet-based PECOS. To revalidate via the Internet-based PECOS, go to https://pecos.cms.hhs.gov on the CMS website. PECOS allows you to review information currently on file, update and submit your revalidation via the Internet. Once submitted, you must print, sign, date and mail the certification statement along with all required supporting documentation to Palmetto GBA immediately.
Can I hold updates to my Medicare information and send them after I receive the revalidation letter?
Proceed with submitting the current changes and await notification to submit the complete revalidation application.
Will I be contacted if my application is found to be incomplete or missing information?
When an incomplete application is submitted or is missing documents, Palmetto GBA will send you an email, letter or fax detailing the missing information or attachment(s). For missing information on the CMS 855 application, the corrected sections of the application along with a new certification statement must be signed by an authorized official. This information can be faxed back to us since we have your original signature on file. If we are only missing supporting documentation you do not need to submit a new certification. You are only required to fax us copies of the missing documentation (e.g., copy of your Internal Revenue Service (IRS) CP-575 form).
What supporting documentation is required to be submitted with the revalidation application?
Licenses, certifications, and registrations required by Medicare or state law; written confirmation from the IRS confirming your Tax Identification Number (TIN) with legal business name; and CMS Form 588 EFT agreement for providers not currently receiving payments electronically.
Are home health agencies (HHA) required to submit capitalization documentation with the revalidation application?
No. Capitalization documentation is not required with the revalidation.
How are HHA branches revalidated?
Each branch location address and PTAN/NPI combination should be reported in Section 4A of CMS Form 855A.
If an HHA has undergone a change of ownership (CHOW) or change in majority ownership, but has not received the revalidation notice, should the CHOW or change in majority ownership be reported or await receipt of the revalidation request?
Proceed with submitting the CHOW or change in majority ownership. Changes of ownership and control must be reported within 30 days of the change.
Do provider types that enroll using the CMS Form 855A have to go through the complete state agency certification process as part of revalidation?
No, recertification is not required.
What address will revalidation letters be mailed to?
Revalidation letters will be mailed to the special payment address.