by nCred | Credentialing Issues, Medicare Provider Enrollment, Provider Enrollment |
Accurate and timely provider enrollment has a dramatic impact on cash flow of any practice. The ultimate goal of any business office, credentialing office, or other responsible staff is to have providers enrolled with health plans as quickly as possible and to...
by nCred | Medicare Provider Enrollment, Provider Enrollment |
Certain healthcare providers are exempt from the DMEPOS Accreditation and Surety bond requirements of participating with medicare as a DMEPOS supplier. These exemptions apply to professional services provider who supply DMEPOS products to their patients, and only to...
by nCred | Medicaid Provider Enrollment, Provider Enrollment |
Primary care physicians who care for Medicaid patients could be eligible for higher reimbursement. Under the Affordable Care Act, state Medicaid programs are required to reimburse primary care services at Medicare rates for 2013 and 2014. The payment increase is...
by nCred | Credentialing Issues, Provider Enrollment |
There is often confusion about federal DEA certificate requirements when providers work in multiple states. The DEA’s policy states that a provider must have a certificate for “each principal place of business or professional practice”. There is an...
by nCred | Healthcare Industry News, Medicare Provider Enrollment, Provider Enrollment |
The Affordable Care Act, Section 6405, requires that physicians who order items or services must be Medicare enrolled providers or Eligible Professionals. The ordering/referring rule was implemented in 2 phases. Phase 1 began October 5, 2009 to alert the billing...
by nCred | Credentialing Issues, Medicaid Provider Enrollment, Provider Enrollment |
Georgia Medicaid plans for centralized credentialing for Medicaid CMO’s The Department of Community Health (DCH) has announced its plan for implementing centralized credentialing for Medicaid and all three CMO’s. Centralized credentialing is targeted to...
by nCred | Medicare Provider Enrollment, Provider Enrollment |
Medicare Ordering/Referring Physician Files (PECOS) Medicare has not yet implemented the automatic denial for claims submitted with an ordering or referring physician who does not have a current PECOS record. CMS is working to clean up system problems and backlogs...
by nCred | Medicare Provider Enrollment, Provider Enrollment |
Poor advice on the internet can lead to making the enrollment process even more confusing than it already is. eHow.com is a large reference site and I came across their article recently that describes “How to Get a Medicare Provider Number”. See their...
by nCred | Medicare Provider Enrollment, Provider Enrollment |
Medicare Ordering/Referring Requirement The Affordable Care Act requires that all eligible providers be enrolled with Medicare to order/refer items to Medicare beneficiaries. Providers who do not submit claims to Medicare must still be enrolled with the program to...
by nCred | Medicare Provider Enrollment, Provider Enrollment |
Medicare Provider Participation Decisions Due By December 31st Medicare providers have until December 31st of each year to make changes to their participation decisions. The Participation Agreement (CMS460) is originally filed with Medicare provider enrollment...
