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Revalidation of Medicare Enrollment

Several years ago, CMS put a new process in place that requires all providers with a Medicare provider number to revalidate enrollment with Medicare on a regular basis.  For physicians, nurse practitioners, physician assistants and CRNAs, it is every five years.  Suppliers, including your optical dispensary, must revalidate every three years.  The process of revalidating occurs through PECOS (Provider Enrollment, Chain and Ownership System) or by submitting the appropriate 855 form.

Do you know when your provider(s) are due to revalidate enrollment?  Sadly, some learn of their deadline when payments stop and they find that their provider number was deactivated for failure to revalidate. 

Your local Medicare contractor should notify you that it is time to complete the revalidation process.  However, you may not want to rely on your MAC notifying you in time.  CMS has a new revalidation website where you are able to determine if you are due.  You may look up your provider(s) by name, NPI or group.  If you are due to revalidate, a due date will appear.  If you are not due, “TBD” appears.  TBD may also indicate deactivation due to failure to revalidate when previously scheduled. 

Visit https://data.cms.gov/revalidation to determine your status.  Check often as CMS updates the list regularly.  You cannot afford to miss this due date. 

As always, we are here to help if you have questions.  Call us at (800) 399-6565.

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