How do I Become a Medicare Part B Participating Provider?

physician and nurse image by Volodymyr Vasylkiv from Fotolia.com

According to an article by Ira Wolfe published by Business2Business, by 2010 some 10,000 Baby Boomers will turn 65 every day. He goes on to say that 20 percent of the American population, or 71,000,000 people will be 65 or older in 2030. These numbers represent increasing opportunities for health care providers to expand their practice and to generate new business. Enrolling as a Medicare Part-B Participating Provider is the first step in positioning yourself to profit from what some have called the “Graying of America.”

Read the document, Internet-based PECOS – Getting Started. This publication will acquaint you with the enrollment process and will also help you to understand the terms used in Medicare as well as explain the information you will need to provide. There is also a frequently asked questions section at the end of the publication which will answer most of your questions.

Get a user id and password from the National Plan and Provider Enumeration System at nppes.cms.hhs.gov. This log-in information is called your National Provider Identifier or “NPI.” Click on “Apply Online for an NPI.” You will need the following information handy to complete the process for your log-in information: Provider name, social security number or Individual Taxpayer Identification Number, date of birth, country of birth, state of birth, gender, mailing address, practice location address and telephone number, Taxonomy or provider type, state license information, contact person name, contact person phone number and e-mail. If you have questions or experience any difficulty in getting your NPI, call 1-800-465-3203 or email customerservice@npienumerator.com.

Log-in to the Medicare website using your NPI and complete the online Medicare Enrollment for Providers and Suppliers at pecos.cms.hhs.gov/pecos/login.do. At the end of this process, you will receive a Certification Statement. If you experience any difficulty during the enrollment process or have questions, you can call 1-866-484-8049 or email EUSSupport@cgi.com.

Print out the 2-Page Certification Statement, sign it, and mail it to the address on the Statement along with the required supporting documents. Your enrollment will be held in abeyance until your signed Certification Statement is received by the Medicare contractor responsible for processing enrollment applications.

Wait about 45 days to receive your Medicare Provider approval. If you receive any requests for clarifications or additional information, you need to respond immediately to avoid unnecessary delays.

Tips

  • The contact person should be your office manager or the person responsible for insurance billings. Otherwise, you will find yourself spending a lot of time answering questions about billings.

References

Resources

About the Author

Don E. Peavy, Sr. teaches philosophy, ethics and religion at the University of Phoenix, Dallas Campus. His published works include “Disaster Among the Heavens," “What Must I Do? Bridging the Gap Between Being and Doing" and “Play It Where It Lies: How to Win at the Game of Life." Peavy holds a Master of Divinity, as well as a Juris Doctor.

Photo Credits

  • physician and nurse image by Volodymyr Vasylkiv from Fotolia.com