Part B Insider (Multispecialty) Coding Alert

Published on Mon Oct 04, 2010 PDF

But, the agency stresses, wait for a request letter before you revalidate.

If you're still waiting for your MAC to send you a revalidation letter, keep an eye out for a brightly-colored envelope, CMS says.

Your revalidation letter will be arriving in an envelope that should stand out compared to the other mail that your MAC sends to you, said CMS's Mark Majestic during CMS's Oct. 27 "Revalidation of Medicare Enrollment" call. The letter will alert your practice regarding how long you have to revalidate your enrollment.

"As long as you do submit those documents within 60 days, there will be no interruption to your billing privileges, no matter how long it takes the MAC to process that revalidation" Majestic said.

The mailing is part of CMS's revalidation effort, which will require all Medicare providers to revalidate their provider enrollment information. If you enrolled in PECOS after March 25, 2011, you should be off the hook, but everyone else will have to face revalidation. You shouldn't do anything until you receive a revalidation request from your MAC--but once they do send you that letter, you should revalidate in a timely fashion.

Know where the letters are coming: If you aren't in PECOS, your revalidation request will go to your "special payments" and "correspondence" addresses simultaneously to ensure that you receive it. If you're in PECOS, the letter will go to the address you have on file in the PECOS system.

Maintain your billing privileges: "Right now the regulations require that failure to respond to a revalidation notice means your provider number will be revoked," Majestic said. "We don't want to take any undue administrative action unless required, so instead of revoking the provider number, we've opted to just deactivate the provider number and allowing the avenue that once they know the number has been deactivated, by submitting the required revalidation documents, their provider number will be reinstated."

Prior to the 60-day expiration timeline, CMS has advised the contractors to make at least two phone calls to the provider number in PECOS to let them know that a revalidation letter was mailed, that they have not responded, and that they must respond. "So we're trying to reach out in every effort we can to make sure that contact is made that you're aware that the revalidation is for you and you're required to submit it," Majestic added.

Keep in mind: Revalidation applies to all practices, big and small, he noted. The vast majority of revalidation notices have not been sent yet, so if you haven't received a revalidation letter, don't fret. "Just wait," Majestic said. "It won't be uncommon for letters to be mailed out until after the first of the year."

Once you submit your revalidation documents, you should receive communication from your MAC confirming that it has received your enrollment application, Majestic added.