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Medicare Administrative Contractor Changes in 2018

In 2018, the Medicare Administrative Contractors (MAC’s) for TN, GA, And AL changed from CAHABA to Palmetto.  The change has had a dramatic impact on the turnaround time of Medicare provider enrollment applications.  A quick sampling of applications processed by nCred in 2018 versus prior years reveals a 64% increase in application completion time for providers in the state of GA; and a 32% increase in turnaround time for providers in the state of TN.  These delays cause financial hardship for healthcare providers desiring to treat Medicare beneficiaries.

Normal provider enrollment application turnaround time

Efficient application processing is done by other MAC’s in less than 60 days, on average, for a standard physician enrollment application.  When applications were being processed by CAHABA for the states of GA and TN their turnaround was well within that time frame and some applications even completed within 30 days!

nCred currently has many client applications open with these MAC’s, and our representatives are consistently told that the application turnaround can be as long as 120 days or more.  We are told that they expect to be caught up with provider enrollment applications submitted in March 2018 no later than the end of August 2018.  The frustrating part is that there is nothing we can do to help speed along the process.  Our repeated calls and pressure has no impact on catching up the work backlog that exists within the Palmetto GBA provider enrollment application processing area.

Medical practices feel the pain

Before a practitioner can be paid for services, they must have an enrollment record on file with their MAC.  Until their enrollment application is complete, they are treating patients with no reimbursement, or waiting to start treating patients.  All the while they have the fixed costs of operating a medical practice while receiving no reimbursement for services.

If you are starting a new medical practice in a Southern state and plan to participate with Medicare, be sure to allow yourself plenty of time to complete the enrollment process.  Call nCred today to discuss any payor credentialing needs you may have.  We work with all medical specialties throughout the country and can assist you with credentialing with any insurance network important to your practice.