decisionhealth Newsletters, Part B News - 2011 Issue 8 (August)
CMS clarifies 60-day revalidation requirement ahead of 2013 deadline
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Article Overview
This piece covers CMS guidance on the 2013 Medicare provider revalidation initiative, including the 60-day response window after a revalidation notice, the role of Medicare Administrative Contractors, and operational concerns for practices managing Medicare enrollment and PECOS updates. It is intended for providers, practice managers, and billing/enrollment staff who need to understand the timing, process burden, and risk of billing disruption associated with revalidation activity.
Why This Topic Matters
It helps organizations anticipate CMS revalidation notices, coordinate enrollment responses, and reduce the risk of Medicare billing suspension or deactivation tied to missed deadlines.
Article Sections
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Revalidation timeline and deadline
Overview of the CMS revalidation initiative and the timing expectations tied to notice receipt and the broader 2013 deadline.
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Submitting an application and managing risk
Discussion of application completeness, processing status, and the general risk considerations associated with timely submission and follow-up requests.
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Letters could come at any time
Operational concerns for practices awaiting revalidation notices and the burden of handling large groups of providers at different times.
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Ordering/referring rule may not matter much
High-level commentary on how the revalidation effort relates to broader Medicare enrollment oversight issues.
What You Will Learn
- How CMS framed the 2013 Medicare provider revalidation timeline
- Why notice timing matters for Medicare enrollment workflows
- What types of operational burdens practices may face during revalidation
- How MAC communication affects provider enrollment planning
- How PECOS and revalidation efforts are discussed in the article
Who Should Read This
- Physicians and other Medicare-enrolled providers
- Practice managers
- Billing and reimbursement staff
- Credentialing and enrollment staff
- Health care compliance professionals
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