Anesthesia Business Consultants Urges Anesthesia Providers to Revalidate Their Medicare Enrollment as Soon as Their Carrie

JACKSON, Mich.--(BUSINESS WIRE)-- Anesthesiologists, nurse anesthetists and anesthesiologist assistants who last validated their enrollment in Medicare prior to March 25, 2011 are going to have to revalidate again by March 23, 2013.

The revalidation is required under Section 6028 of the Affordable Care Act. According to this statutory provision, all providers and suppliers who were initially enrolled before March 25, 2011 and have not revalidated since then must revalidate their enrollment information within 60 days of receiving notice from their carriers, but no later than March 23, 2013.

This new revalidation program is intended to combat Medicare fraud, by bringing all providers within a new tiered screening process.

Under this new process, physicians and non-physician practitioners other than physical therapists are in the lowest tier and are classified as “limited” risk. Pending the arrival of the notices from your own Medicare Administrative Contractors (MACs), be aware of the following:

  1. You will have 60 days from the date of the revalidation request letter to submit complete enrollment forms. Do not try to start the process before you hear from your MAC.
  2. Failure to comply may result in the deactivation of your Medicare billing privileges and a freeze on payments.
  3. Be on the lookout for the letter from your MAC; it may go to your place of work, or your business office, or any other address that Medicare has on file for you.
  4. You may revalidate using either the Provider Enrollment Chain Ownership System (PECOS) website or a paper CMS-855 application. CMS explicitly prefers PECOS.
  5. The application must be complete and contain your entire enrollment data.
  6. Remember to send in your supporting documentation, e.g. IRS form CP-575 showing your employer identification number.
  7. If you use the online PECOS system, be sure to mail in the signed certification statement within seven days.

The PECOS option is currently cumbersome, as the many anesthesiologists, CRNAs and AAs who had to re-enroll within the past several years know all too well. Word has it that CMS plans to begin implementing some significant changes by January 1, 2012. These changes may (and should!) include allowing document uploads and electronic signatures, enabling bulk upload capabilities for multiple revalidations from a single group, and permitting administrative staff to create their own PECOS identities so that they do not have to use the clinicians’ logins and passwords.

As always, ABC will work with our clients to respond to the MACs’ revalidation requests. For a full summary on this new development, please check out ABC’s coverage here:

About Anesthesia Business Consultants

ABC, established in 1979, is one of the largest billing and practice management companies dedicated to the complex and intricate specialty of anesthesia and pain management. It is both an American Society of Anesthesiologists Practice Management Supporter, and an Anesthesia Quality Institute Preferred Vendor. ABC employs industry leaders, operates under proven efficient processes, and utilizes technology advances to easily adapt to the ever-changing regulatory environment.

If you would like more information about this topic, please go to [email protected].


Anesthesia Business Consultants
Tony Mira
Tel: 517-787-6440
Email: [email protected]

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