Medicare revalidation FAQ

Q: How will I know when it’s time for me to revalidate? Should I submit my revalidation application now?

A: First Coast Service Options, Inc. (First Coast) will be mailing revalidation request letters-- enclosed within yellow envelopes -- to affected providers.





You will know when it is time for you to revalidate when you receive a revalidation request letter from First Coast. You should not submit your enrollment application (e.g., CMS-855I, CMS-855B, CMS-855A) until you have received your revalidation request letter.

Q: When will I receive my revalidation request letter? Is there an easy way for my staff to identify the letter?
A: First Coast Service Options, Inc. (First Coast) will be mailing revalidation request letters to affected providers. You may receive a revalidation request -- enclosed within a yellow envelope -- at any time during that time period.

How to easily identify the revalidation request letter:
validation request envelope
• The revalidation request letter will be enclosed within a yellow envelope
• The phrases Open Immediately and Urgent Request will be stamped on the yellow envelope
• The return address will list First Coast
• Click here external pdf file to view a sample revalidation letter on the CMS.gov website.
http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/Downloads/SampleRevalidationLetter.pdf


Q: How long do I have to submit my revalidation application? What will happen if I don’t respond?

A: Once you have received your revalidation request, please don’t wait. First Coast Service Options, Inc. (First Coast) must receive your enrollment application within 60 days.
Note: If First Coast does not receive your application within 60 days, your Medicare payments will be withheld, and your billing privileges will be deactivated. You will be required to submit your enrollment application to reactivate your billing privileges.



Q: I just received a revalidation request letter from First Coast Service Options Inc. (First Coast). Where can I find more information regarding the provider revalidation process and how to properly respond to a revalidation request?

A: First Coast Service Options (First Coast) will be mailing revalidation request letters to affected providers. You may receive a revalidation request -- enclosed within a yellow envelope -- at any time during that time period.

A revalidation is a complete and thorough re-verification of the information contained in your Medicare enrollment record to ensure it is still accurate and compliant with Medicare regulations.


CMS 855O Enrollment Form

Must enter into a private contract with patients for Can become an active billing Medicare provide covered Medicare services prior to the service at any time by submitting the CMS 855I enrollment being performed (exception for emergency care application (and any additional information or services as defined by CMS). enrollment forms required).

CMS 855I Form The CMS enrollment application for an individual to complete to enroll in Medicare if they plan to bill Medicare for covered services.

https://www.healthlawyers.org/Events/Programs/Materials/Documents/MM12/papers/V_joy.pdf

CMS 855 application not needed (most common—individual physician submits an 855i at the same time the physician submits an 855r to reassign to new group and there are no changes in the 855i application).

a. Practice Note: It is helpful for physicians to complete an 855i change of information application to update their correspondence addresses when reassigning to new groups.

b. Physicians should also submit 855r applications to terminate old reassignments or individual practice PTAN numbers.

c. Caveat: Some MACs mistakenly treat the 855i change of information applications as superfluous if the physician already has a record in PECOS and these changes are not always processed. (Basically the processors miss the fact the physician is changing information).

d. If a physician is reassigning to a group that has more than one PTAN number under a single Tax ID number, only one 855R is required, but we recommend sending a separate 855R for each PTAN to ensure that the notification letter, which contain the newly issued PTAN numbers are issued for each group PTAN number. Some MACs have difficulty issuing separately PTAN letters when only one 855r is filed.

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