Αποτελέσματα Αναζήτησης
• 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.
Medicare Enrollment Application: Clinics/Group Practices and Other Suppliers (CMS-855B): Group practices and other organizational suppliers, except DMEPOS suppliers, use this form to begin the Medicare enrollment or revalidation process or to change enrollment information.
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. •.
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. CMS-855I (PDF) for Physicians and Non-Physician Practitioners.
• 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.
Choose an enrollment eligibility selection that applies to you on the irst page. Check the appropriate box for the plan you wish to join. Choose a primary care provider (PCP), if applicable. To conirm that your doctor, clinic or health center is part of the Priority Health Medicare network of providers, go to
The CMS-855R application is used by individual physicians and non-physician practitioners (hereafter collectively referred to as “individual practitioners”) who want to reassign their right to receive Medicare payments to another eligible individual or entity (i.e., sole
