Revenue Cycle Insider

Question: I need to make an adjustment to the credentialing information for one of my providers. Does this situation require filling out a new provider enrollment form?

North Carolina Subscriber

Answer: According to the Medicare Administrative Contractor (MAC) Palmetto GBA, there are different forms available depending on whether the information change involves an individual physician or a practice at large.

 Look for the following forms when you need to make changes to Medicare provider paperwork:

• CMS 855B: “This application is used to enroll new health care organizations, such as group practices, or to make changes to an existing health care organization’s Medicare records.”
• CMS 855I: “This application is used to enroll new individual physicians or nonphysician practitioners, or to make changes to include new reassignments to an existing individual physician or nonphysician practitioner’s Medicare records.”

Palmetto GBA also recommends filing the paperwork electronically through the Medicare Provider Enrollment, Chain, and Ownership System (PECOS) website, where applications may be processed up to 50 percent more quickly than paper applications. 

Rachel Dorrell, MA, MS, CPC-A, CPPM, Development Editor, AAPC