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  1. If you're a Michigan provider interested in joining our network, see our service area maps and follow the steps outlined below. It can take up to 80 calendar days for us to process your enrollment request.

  2. Learn how to initially enroll, revalidate, and submit changes of information for individual providers. Cover all aspects of completing the CMS-855I & 855R with a walkthrough of both the paper and PECOS versions of the form. Learn how to avoid common mistakes when submitting the 855-I&R. •.

  3. How to Submit Reassignment of Benefits Using the Revised CMS-855I. Physicians and non-physician practitioners can enroll and report reassignments using either: The Provider Enrollment, Chain and Ownership System (PECOS), or. The Paper CMS-855I Application.

  4. ENROLLMENT. Health care providers must enroll in the Medicare Program to get paid for providing covered services to Medicare patients. Learn how to determine if you’re eligible to enroll and how to do it. Who Are Institutional Providers? ⤵

  5. terminate a reassignment of Medicare benefits after enrollment in the Medicare program or make a change in their reassignment of Medicare benefit information using either: • The Internet-based Provider Enrollment, Chain and Ownership System (PECOS), or • The paper CMS-855R application. Be sure you are using the most current version.

  6. Paper Enrollment Applications. The following forms can be used for initial enrollment, revalidations, changes in status, and voluntary termination: CMS-855A (PDF) for Institutional Providers. CMS-855B (PDF) for Clinics, Group Practices, and Certain Other Suppliers.

  7. Medicare has merged the CMS-855R into the CMS-855I paper enrollment application. Physicians and non-physician practitioners can reassign your right to bill the Medicare program and receive Medicare payments for some or all the services you render to Medicare

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