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Understand the Signing of the Medicare Contract for Physicians


About this program


Physicians and other healthcare providers should be making informed decisions about their contractual relationships with the Medicare program. Has your healthcare provider ever analyzed what he or she is signing when entering into a contract with Medicare? Have you ever completed and signed a Medicare Enrollment application form on behalf of your physician? Presenter Maxine Collins has and says: “At the time, I did not fully comprehend all the content in the paperwork.” Often there is an urgency to complete the application quickly in an effort to get the provider enrolled. The form is lengthy and some fields may be difficult to answer if you are not fully versed in contractual language.

While there is more than one type of Medicare Enrollment Application, most share common language and provisions. In this session, practice management expert, Maxine Collins, will review some of the most important terms found in form CMS-855B - Medicare Enrollment Application - Clinics/Group Practices and Certain Other Suppliers. This is the application commonly completed by healthcare practices seeking to enroll in the Medicare program and receive a Medicare billing number.

When you sign the application, you are attesting to having read all of the requirements and understanding them and you are agreeing to adhere to all applicable Federal and state requirements. This is a major commitment and warrants a thorough review of the details to which you are attesting. Be sure you know the requirements listed in the Certification Statement which are officially binding and could potentially place the provider in a position to be denied entry to or revoked from the Medicare program if they are not met. Understand the additional requirements for Medicare Enrollment for Authorized Officials.

In this Lunch and Learn program, Ms. Collins will not have enough time to review the entire enrollment application but will instead focus specifically on a few key sections - Certification Statement, Final Adverse Legal Actions and the time period it can impact, Exclusion from the Medicare program and penalties for falsifying information on the application. Important details to be addressed in this session:

  • Why you should read the "small print"
  • Titles and acronyms used in the Enrollment Application, i.e., Authorized Official
  • What does Final Adverse Legal Actions mean?
  • What is an "Exclusion" and is your organization checking this?
  • OIG enforcement activities and potential penalties

Don't miss this valuable look into the Medicare Enrollment Application process. Navigating the rules in healthcare has always been complex. Knowledge is the key to success. This presentation will provide some important information to help you along the way.