Hello,
I ran into a provider that had some CMS/fraud issues and is in need to reestablishing Medicare relationship. He has an hearing set up within the next month by phone with CMS regarding the issue. However, he's been told by CMS customer service and credentialing office that he can complete the enrollment form, however, he hasn't been officially told by the closings of his hearing. He wants to submit claims for payment. I am under the impression, that generally, yes he needs to complete enrollment forms to reactivate his provider number, NPI, etc but in order to actually submit claims, he would have to obtain a final ruling, is this correct? Also, he states that he was told by CMS that claims prior to the exclusion can be submitted, is this correct?
Your assistance will be most helpful!!
Thank you,
Dawn