[NPInfo] Medicare info part 2

Mon Feb 26 08:36:41 PST 2007

Hi,  One of the things to do is call the Medicare call center 1800 933 0614, and they can check to see if other places of employment are still using or making claims with your medicare number. Also call the enrollment number 1888 608 8816, and to re enroll or get your own independent Medicare billing number you must download a long form off www.noridianmedicare.com   called an 855I, it is approximately 30 pages. Some of it does not apply to NPs, so the Medicare office can assist with this.  After starting to research this, another NP (Meg) found this info below, not sure which website, but I will find out more as I go along, have to get to work, Carla/Portland

Novice Know-How - Requirements for Provider Changes to Provider 
Enrollment Information
The Centers for Medicare & Medicaid Services (CMS) requires that a 
provider must notify Medicare of certain Provider Enrollment information 
changes within 90 days.

In order to prevent a Do Not Forward (DNF) flag from being added to a 
provider file, a provider must promptly report Special Payments address 
and/or Bank Routing/Account number change(s) to the carrier's Provider 
Enrollment department. Medicare cannot forward checks and Remittance 
Notices if a provider's file is flagged with DNF. Once effectuated, a DNF 
Flag cannot be removed from the provider's file until a CMS Form 855 
application is received to notify Medicare of the updates.

At this time, CMS requires that any individual, group, or organization 
making a change to their pay-to address (Special Payments address) 
without an initial enrollment application (CMS Form 855) on file must 
complete one in its entirety before a change is made to a pay-to address. 
For example, if you or your organization enrolled prior to 1998, this may 
affect you.

An individual solo practitioner must complete a CMS Form 855I for any 
of the following changes to his/her 'Individual Medicare file':

    * Name changes/updates (marriage, divorce or legal name change)
    * Address additions/deletions
    * Adding/changing a Billing Agency
    * Changing/updating the provider specialty
    * Changing/updating an effective date or termination date

IMPORTANT>>>>>>>>>>>
****An organization must complete the CMS 855B for the following 
changes to their 'Organization/Group Medicare file':

    * Changing/updating an effective date or termination date
    * Address additions/deletions
    * Adding/changing a Billing Agency
    * Changing/Deleting the Authorized Official
    * Changing/Deleting the Delegated Official
    * Terming a Physician Assistant PIN within your group

Group members must complete the CMS Form 855R to make the following 
changes to their reassignment:

    * Terminate a current Reassignment
    * Change the effective date/termination date on a reassignment

Lynda Woiblett <lwoiblett at msn.com> wrote:
  Hi Carla,

I am aware of what you are saying but I have never known how to find out if, 
indeed, all the doors have been closed..do you happen to know how to find 
out this information?

Lynn W

>From: Carla Anderson 
>Reply-To: NP Info 
>To: NP Info 
>Subject: Re: [NPInfo] Medicare info
>Date: Sun, 25 Feb 2007 22:36:08 -0800 (PST)
>
>Hi everyone,
>
> I was not aware of this as I practiced in California before under a 
>large hospital organization and did not have my own Medicare number. But 
>when you work for an organization, and get credentialed, you get assigned a 
>UPIN number, + a separate Medicare billing number that is attached to the 
>Tax ID number of the place of employment you work at. This is usually 
>accomplished by filling out 855 R and 855 B forms. When you leave your 
>place of employment you and the organization you work for are supposed to 
>contact Medicare and cancel that billing number. Then when you go work for 
>another organization, you get another different Medicare billing number, 
>but you will still have your UPIN number. In addition, you will have an NPI 
>number which will cross link with your Medicare number in May 07, and may 
>eventually replace it entirely at some point. But if you do not cancel 
>your Medicare billing number at your previous place or places of 
>employment, these numbers are still "open"
> or considered "active" at those institutions, and someone could with or 
>without intent use them to file claims. Now to Medicare it would look like 
>you were the provider filing those claims, and if you were not, and there 
>was intent, this is fraud. Providers often work at more than one place, 
>even in two different states, so having different claims with different 
>Medicare numbers for the same provider does not necessarily raise a red 
>flag to Medicare...So it is important to close all your doors so to speak 
>as you leave. I just learned some information recently, and will not go 
>into all the details here, but wanted to inform any of those of you on the 
>list that may not have known this. Carla/Portland
>
>"Colleen A. VanGelder" wrote:
> I'm brand new to this email list - Hello!
>I'm a GNP in Tucson, Arizona and the weather here is BEEEYOOOTTTEEEEFULLLL 
>today!
>Sunny, robin's egg blue sky, slight breeze from the west and 74 degrees... 
>and we can go visit the snow in the US's southernmost mountain range (a 45 
>minute drive) anytime we'd like!
>Thanks for the updates from around the country!
>Colleen VanGelder
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