Changes to Provider Enrollment Information

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  1. What is the procedure for changing my enrollment information?
  2. I originally enrolled with a temporary license and am now ready to submit my permanent license. How do I report this to WPS?
  3. What are Medicare's requirements for reporting Diabetes Self-Management Training (DSMT) accreditation?
  4. What are Medicare's requirements for reporting accreditation for advanced diagnostic imaging services (ADI)?
  1. What is the procedure for changing my enrollment information?

    Providers are required to notify WPS Medicare's Provider Enrollment Department of any changes to information on their enrollment record by reporting it on the appropriate CMS-855 enrollment form. Depending on the provider's specialty and the type of change involved, notification is required within 30 days or 90 days of the effective date of the change. For detailed information regarding the requirements for reporting of changes of information, refer to "Reporting Changes of Information".

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  3. I originally enrolled with a temporary license and am now ready to submit my permanent license. How do I report this to WPS?

    Submit your permanent license information on the CMS-855I application form as a change of information, including a new signature and date in Section 15. Include your NPI on the form and enclose a copy of your permanent license.

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  5. What are Medicare's requirements for reporting Diabetes Self-Management Training (DSMT) accreditation?

    DSMT is not a separately recognized provider specialty. A person or entity cannot enroll in Medicare for the sole purpose of performing DSMT. Rather, DSMT is an extra service for which a currently-enrolled provider can bill, if it meets all of the necessary DSMT requirements.

    All DSMT programs must be accredited as meeting quality standards by one of the CMS-approved national accreditation organization, which currently are the American Diabetes Association (ADA), American Association of Diabetes Educators (AADE), and the Indian Health Service (IHS). A Medicare-enrolled provider that wishes to bill for DSMT should submit the ADA, AADE, or IHS certificate to Wisconsin Physicians Service, Medicare Provider Enrollment, along with a cover letter from the provider or the authorized or delegated official. (DSMT accreditation is not represented on the CMS-855 enrollment forms, so it is not necessary to submit a CMS-855 enrollment form for this purpose.) A copy of the renewal certificate must be submitted each time the current accreditation period expires.

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  7. What are Medicare's requirements for reporting accreditation for advanced diagnostic imaging services (ADI)?

    Although Section 2H of the CMS-855B and Section 2L of the CMS-855I enrollment forms currently include fields for reporting ADI accreditation information, this information is not to be reported to Medicare directly by providers. Rather, this information is reported to the Medicare program by the accrediting organizations and is populated to providers' records in the Provider Enrollment, Chain and Ownership System (PECOS) and the claims processing system. The ADI fields will be removed from the CMS-855 enrollment forms with the next revisions.

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Page Last Updated: Monday, 09-Apr-2012 15:13:27 CDT