tci Medicare Compliance & Reimbursement - 2022 Issue Q4

Reader Question: Figure Out Which CMS-855 Best Applies to Your Organization

Question: At our rural practice, we have one doctor, and she wants to enroll as a Medicare provider. Does she need to fill out a form? What is the easiest way for her to apply? Montana Subscriber Answer: There’s a common belief that medical licensure allows providers to immediately bill Medicare for services rendered, but that’s not the case. There’s actually a process that starts with either getting a national provider identifier (NPI) or confirming one through a query via the National Plan and Provider Enumeration System (NPPES). Remember: “Covered health care providers and all...

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