Credentialing & Enrollment
Resources and links to help answer many of your questions. Please visit often for the latest information. Have questions? Contact us today!
- Medicare Application Fee for Institutional Providers
- Section 6401(a) of the Affordable Care Act (ACA) requires the Secretary to impose a fee on each "institutional provider of medical or other items or services and suppliers." The fee is to be used by the Secretary to cover the cost of program integrity efforts including the cost of screening associated with provider enrollment processes, including those under section 1866(j) and section 1128J of the Social Security Act.
- Medicare Enrollment Fees: Medicare Enrollment Application Information (hhs.gov)
- CMS Enrollment Forms: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/Enrollment-Applications
- Council for Affordable Quality Healthcare (CAQH) - http://www.caqh.org/
- Provider Revalidation
- In accordance with the Patient Protection and Affordable care Act, Section 6401 (a), all new and existing providers must be reevaluated under the new screening guidelines in Section 6028. Medicare requires all enrolled providers & suppliers to revalidate enrollment information every five years.
- Click here for a Sample Revalidation Letter.
- Click here for a list of providers & suppliers that have been issued a letter in Phase 1.
- Click here for a copy of SE1126 MLN Matters for further details on the revalidation of provider enrollment information.
- Click here to be directed to the CMS site for more information on the mandatory revalidation.