Changes to Medicare Reactivation Effective Date
Currently, a provider’s Medicare billing number (Provider Transaction Access Number or PTAN) will be deactivated after twelve months of inactivity. If a provider does not bill for any services with a specific group for 12 months, Medicare will terminate their affiliation with that group. In order to reactivate a provider with a group, a reactivation application must be submitted to Medicare. Recently, CMS made changes to their policy regarding the effective dates of these reactivations. Previously, we were able to reactivate a provider’s group affiliation retroactively. This is not longer the case. According to the WPS Medicare Part B website:The effective date for the new PTAN is the later of the filing date of the Medicare enrollment application for reactivation, or the date the provider first started furnishing services at the practice location indicated on the application.Consequently, if a provider has not worked with your group in over a year, it is imperative that we submit their reactivation application before they begin providing services to Medicare patients or your group will not be reimbursed for the cases that they perform prior to submission of the application.We understand that this can be difficult task, especially for those groups who must fill an immediate void and those groups who regularly use agency CRNAs. We have voiced these concerns to our local Medicare carrier; however, this decision has been handed down by CMS. As a Medicare provider, if you wish to voice a complaint, please contact the CMS Associate Regional Administrator, Gregory Dill at 312-353-9841 or ROCHIFM@cms.hhs.gov. If you have any questions regarding reactivating a provider, please contact our Credentialing Specialists:Shannon Collins – 586.264.3500 extension 121 / scollins@armgmt.comorLeslie Hochadel – 586.264.3500 extension 132 / lhochadel@armgmt.comPlease note: this change does not affect providers who are new to the group. In this instance, Medicare will still allow a retroactive effective date up to 30 days prior to the submission of the enrollment application.« All News
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