Provider Enrollment Revalidation Cycle 2

Provider Enrollment Revalidation Cycle 2

All Medicare Part A and B providers are required to recertify the accuracy of their enrollment information every five years through a process known as revalidation. The initial five year revalidation cycle was completed in 2015 and the Centers for Medicare & Medicaid Services (CMS) began Cycle 2 in March 2016.

CMS implemented improvements to streamline the revalidation process during Cycle 2. One enhancement is that CMS is establishing due dates with six months of advance notice for when the revalidation application must be received to remain compliant with Medicare’s provider enrollment requirements. CMS posts the due dates for all currently enrolled providers in the Medicare Revalidation Lookup Tool at Data.CMS.gov/revalidation. A due date of “TBD” means that CMS has not set the date yet. Please do not send a revalidation application if there is NOT a listed due date. First Coast will return any unsolicited revalidation applications received earlier than six months before the due date, or when a due date is not yet listed.

The Revalidation Lookup Tool is updated every 60 days, so we encourage providers to check the tool periodically and respond timely once your due date is established. First Coast is also issuing notices by mail to providers two-three months before the due date.

An important change for Cycle 2 is that failure to submit a revalidation application will result in possible deactivation of a provider’s Medicare enrollment and billing privileges. Please note other important impacts:

  • If the revalidation application is received, but additional information is requested (through development) and not received within the 30-day timeframe, the provider’s Medicare enrollment will possibly be deactivated
  • Requests for application submission extensions will not be granted
  • Be sure to submit the application fee, if applicable

Please access the following key resources for additional information:

  • MLN® Special Edition (SE) 1605 article

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1605.pdf

  • Steps for completing the revalidation process

http://medicare.fcso.com/PE_Revalidation/269940.asp

  • Revalidation Cycle 2 FAQs

https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/Downloads/Reval_Cycle2_FAQs.pdf

  • First Coast’s on-demand webcast recording “Provider Enrollment Revalidation – Cycle 2”

https://gm1.geolearning.com/geonext/fcso/coursesummary.CourseCatalog.geo?src=CourseCatalog&selectTab=Details&id=22507369817  (Note: To access the recording, request a free training account at First Coast University).

 

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