UPDATED FROM JANUARY 24th, 2022
Dear Chiropractors, Office Managers, and Insurance Personnel:
“The Center for Medicare & Medicaid Services is continuing to populate providers’ re-validation due dates from a ‘TBD’ date to an actual due date.
Per CMS (data.cms.gov):
- The re-validation data was last refreshed on August 01, 2022.
- ‘Adjusted’ Re-validation Due Dates for October 2022 have been added.
- The next data refresh is tentatively scheduled for September 1, 2022.
- Affiliations now include reassignments as well as Physician Assistant(PA) employment relationships.”
https://data.cms.gov/tools/medicare-revalidation-list
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January 24th, 2022
As you may be aware, the Center for Medicare and Medicaid (CMS) made an accommodation during the pandemic regarding your doctor re-validation due date with Medicare. As such, CMS will be adjusting doctors’ re-validation due dates in phases starting this quarter. The Medicare Enrollment online tool, PECOS, has shared information on their homepage that enrollment re-validation has resumed in a phased approach for active providers.
What this means for you: It is critical that you check your re-validation due date and re-validate your Medicare enrollment prior to your due date. If you don’t re-validate, claims will most likely deny when their software program catches a mismatch to enrollment due dates, and you may lose your billing privileges. If you reassign your benefits to your group/Type 2 NPI, you will need to re-validate the group enrollment as well. The re-validation requirement holds regardless of if you are a participating or non-participating provider. There is no fee to re-validate.
CMS has stated they will notify providers via email on file, or mail, approximately three to four months prior to their adjusted due date. You can check your re-validation due date here:
https://data.cms.gov/tools/medicare-revalidation-list
Once you open the page, you will see two due date boxes. You may disregard the original due date shown on that page. The box to pay attention to is the “Adjusted Due Date”. If it states TBD, keep checking every couple of weeks to see if that field has been populated to show your adjusted due date.
How do you re-validate? Use online PECOS (the preferred method), linked here: https://pecos.cms.hhs.gov/pecos/login.do#headingLv1
Or submit a paper 855i application, found here: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads/cms855i.pdf
References:
Please see the initial communication here:
https://pecos.cms.hhs.gov/pecos/login.do#headingLv1
Additional related links:
https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/Revalidations
https://www.cms.gov/files/document/provider-enrollment-relief-faqs-covid-19.pdf
Contact us if you have any questions – we’ve got you covered!
(This includes if you can’t get into your PECOS account because it’s been so long, or because of staff changes, or because you forget your password, call us and we can help you.)
Lisa Barnett
920-334-4561
Petty, Michel & Associates
Email: lisa@pmaworks.com, dave@pmaworks.com