MiraMed Global Services Comments on the Centers for Medicare & Medicaid Services Moving Forward on Major Healthcare Provider Revalidation Effort

MiraMed Global Services Comments on the Centers for Medicare & Medicaid Services Moving Forward on Major Healthcare Provider Revalidation Effort

<0> MiraMed Global ServicesTony Mira, 517-787-7432Email: </0>

MiraMed Global Services (MiraMed) comments in their October 7 on how the Section 6401(a) of the Affordable Care Act established a requirement for all enrolled providers and suppliers to revalidate their enrollment information under new enrollment screening criteria. This revalidation effort applies to those providers and suppliers that were enrolled prior to March 25, 2011. Newly enrolled providers and suppliers that submitted their enrollment applications to the Centers for Medicare & Medicaid Services (CMS) on or after March 25, 2011 are generally not impacted.

CMS will soon begin the next phase of revalidation (Phase III) which consists of revalidating all remaining providers including providers reassigning their benefits to some of the large organizations they are affiliated with. Large organizations are considered as groups with 200 or more reassignments. CMS will provide the Medicare Administrative Contractors (MACs) nine lists every 60 days of those providers required to revalidate. MACs will have 60 days from receipt of the list to mail the letters. MACs may stagger the mailings however they see fit as long as they are completed within that 60-day timeframe.

Within 15 days of receiving the CMS list, MACs will mail a notification letter to the large organizations notifying them that members of their group will be receiving a request to revalidate in the next 60 days.

CMS encourages providers/groups to revalidate online. Doing so gives the providers/groups a head start. They are able to prepare the information in advance but should wait to submit it and e-sign until the revalidation letter is received.

Revalidation letters are sent to the provider’s special payment and correspondence address. If the provider reassigns to multiple groups and another group’s address is listed as their special payment address/correspondence address, that group will receive the letter. If your group is responsible for maintaining the provider’s enrollment then you should work with your providers to update their correspondence address to match yours or have them on the lookout for the revalidation letter.

Extensions are still available if more time is needed to complete the revalidation process. Extension requests should be coordinated with your MAC. If needed, CMS will coordinate group extensions rather than requiring each provider to request an extension individually. At this time, CMS is not permitting groups to revalidate multiple providers using the spreadsheet provided as part of the group notification.

You may find further information about this revalidation on the CMS .

Headquartered in Jackson, Michigan, MiraMed Global Services stands as the premier global provider of business process outsourcing solutions to healthcare organizations nationwide. MiraMed partners with hospitals, health networks, physician practices and related industry service organizations to provide a broad portfolio of customizable solutions, uncover and capitalize on hidden financial opportunities, improve productivity and ultimately increase profits.

MiraMed pairs healthcare industry experts with world-class processes, infrastructure and technology to deliver meaningful and measurable results. This proprietary model enables sustainable change by delivering a complete, customizable "end-to-end" solution devised to meet a client's own unique financial and organizational needs. Visit MiraMed at: .