Centers for Medicare & Medicaid Services

REVALIDATION NOTICE

The Centers for Medicare & Medicaid Services (CMS) is in the process of revalidating all new and existing providers. This revalidation applies to providers/suppliers enrolled prior to March 25, 2011.  Through June 30, 2013, Novitas Solutions will be sending revalidation notices to all providers and suppliers affected.  The provider/supplier has 60 days from the post mark date of this letter to submit complete enrollment information. 

Failure to submit complete enrollment application(s) and all supporting documents will result in your Medicare billing privileges to be deactivated.

CMS requires revalidation to ensure CMS has updated information on providers such as practice locations, legal business name, Tax ID, SSN, certifications, etc.

If this seems like a “small issue,” think again. The consequences of not revalidating are severe.  Providers who do not response to the revalidations letters within 60 days will be deactivated with Medicare and will need to re-credentialed which does not guarantee back dating effective dates.

Below is the following schedule which Novitas Solutions will be following on a regular basis:

PHASE 1 – Providers/Suppliers not in PECOS

  • September 16, 2011

PHASE 2 – Providers/Suppliers no in PECOS but Enrolled Prior to March 25, 2011

  • March 1, 2013 (Jurisdiction H – Including IHS providers/suppliers)
  • March 15, 2013 (Jurisdiction H)
  • March 29, 2013 (Jurisdiction H)

There are two ways to revalidate. Please see the information below. This information can also be viewed in the CMS revalidation letter.  For your convenience, Clinic Service has posted a copy of the letter on its website that you can view by clicking here. The provider or supplier has 60 days from the date of the letter to submit an Internet-based PECOS application or a paper application.

If additional time is required to complete the revalidation applications, you may request one 60-day extension, which will begin on the date of the request. The request may be submitted in writing from the individual provider, the Authorized or Delegated Official of the organization or the contact person and addressed to the MAC(s). The request should include justification of why a 60-day extension is needed. The request may also be made by contacting your MAC(s), via phone (see below).

  1. Internet-based Provider Enrollment, Chain, and Ownership System (PECOS) To revalidate via the Internet-based PECOS, go to https://pecos.cms.hhs.gov. This system allows you to review information currently on file. Please select “Revalidation” as the reason for submission. Please note, Internet-based PECOS now allows providers and suppliers to sign Medicare enrollment applications electronically eliminating the need to mail the hardcopy certification statement to the MAC(s). If mailing the hardcopy certification statement, remember to print, sign, date, and mail it along with all required supporting documentation. To process the revalidation, the original signature and/or supporting documentation must be received within 15 days of the application internet submission date. You must have an active National Provider Identifier (NPI) and have a web user account (User ID/Password) established in NPPES (https://nppes.cms.hhs.gov/NPPES/Welcome.do). Physicians and non-physician practitioners will access Internet-based PECOS with the same User ID and password that they use for NPPES.
  2. Paper Application Form To revalidate by paper, download the appropriate and current CMS-855 Medicare Enrollment application from the CMS Web site at https://www.cms.gov/MedicareProviderSupEnroll/. Please select “Revalidation” as the reason for submission. Mail your completed application, all required supporting documentation and a copy of this letter to Novitas Solutions at the address below:

NOVITAS SOLUTIONS
Provider Enrollment Services
P.O. Box 890095
Camp Hill, PA  17089-0095
Phone:  (855) 252-8782