decisionhealth Newsletters, Part B News - 2007 Issue 10 (October)
Revalidation: What to do when carriers demand new 855s; What to do if you must revalidate
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Article Overview
This article covers Medicare provider revalidation requests for practices and health systems, with guidance on how to recognize a notice, confirm who received it, and understand the timeframe and administrative steps involved. It is aimed at billing staff, practice managers, compliance personnel, and providers who handle enrollment maintenance. The discussion focuses on revalidation logistics, contact information accuracy, correspondence handling, and the broader implications of missing a required revalidation response.
Why This Topic Matters
Revalidation affects whether a practice can keep its billing privileges and continue receiving Medicare payments. The article helps readers understand the administrative process and the importance of timely enrollment maintenance.
Article Sections
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What to do if you must revalidate
Overview of how practices may be notified about revalidation and the administrative steps involved in responding. The section discusses enrollment form handling, contact verification, timing, and preparation considerations.
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Not revalidating could mean lost billing privileges
Summary of the consequences associated with failing to complete revalidation within the required timeframe. This section references Medicare policy guidance and the possible effect on billing privileges.
What You Will Learn
- How revalidation notices may be communicated to practices
- What administrative information should be checked when a notice arrives
- Why maintaining current enrollment contact information matters
- What timing considerations apply to the revalidation process
- What general consequences are associated with missing a revalidation request
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Compliance staff
- Healthcare providers
- Enrollment specialists
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