Medical Billing Forum

NPI Numbers => NPI Numbers => : Reinfryt July 18, 2009, 04:14:29 PM

: 855I form
: Reinfryt July 18, 2009, 04:14:29 PM
Dear Medical Biller,
     I have obtained a Group NPI number and filled out my Medicare 855I aplication form. My new practice will open for business September 23 and I will start seing Medicare patients.How soon may I send in my 855I application so I can have a new Medicare number to start billing the first day of my new practice? Thanks Reinfryt
: Re: 855I form
: PMRNC July 18, 2009, 05:15:16 PM
You can send it in now, if it's not processed by the time you begin seeing patients, just hold the claims until it's approved and then you are set.
: Re: 855I form
: Steve Verno CMBS, CEMCS August 08, 2009, 10:57:17 AM
When completed, Medicare will send you a form, letting you know you have completed the enrollment process. It will show your effective date which is the date they go back to for claims payment.  Example:  if Medicare says your effective date is June 1, 2009, claims from June 1, can be sent and if a covered service can be paid. May claims might not be paid because you werent effctive at that time. We would sent our Medicare vendor, a letter, with a copy of the providers contract, asking that the effective date be backdated to the date of the hiring contract.  They stopped doing this.

The practice would hire a new provider and immediately have that provider treat patients. When the charts were sent for coding and billing, this new provider wouldnt show in our system.  That caused many issues.  We tried to get the practice to send the provider to us for enrollment during the hiring and interview process but they stopped.  Medicare sent the practice a warning letter which contained language they would refuse to backdate any effective date.  Now they enroll as quickly as possible because it usually takes 4 months here to complete the enrollment process.