Provider Enrollment
Provider Enrollment
Enrollment Submission & Process
CMS 855s: Temporary Suspension of Processing Specialty Hospital Enrollment Applications
CMS 855A: Medicare Enrollment Application - Institutional Providers
CMS has developed a Provider Enrollment brochure and they have placed it on their website. This brochure is informational for new Medicare Providers, and also for Medicare providers who want to understand more about the enrollment process.
Use of 9-digit zip codes for the 855A application
Effective 07/01/07, all providers must include a valid 9-digit zip code on section 4a (practice location) of the CMS 855A application form for any application type submitted.
If a provider's claim is RTP'd for an invalid 9-digit zip code, the provider must submit an 855A application with a valid 9-digit zip code for the facility's practice location.
Please note: If we do not have a current 855A application on file, a provider will be required to submit all sections of the 855A application in order to process the necessary changes.
WPS Medicare FAQ for Provider Enrollment
To enroll in Medicare as a provider or make changes to your existing Medicare information, you must complete the CMS-855A application. Per the Program Integrity Manual, Chapter 10, Section 7.1.1, you must submit a complete CMS-855A if you have not completed and full 855A application in the past few years.
Timeframes:
You can help us process your application by submitting complete, accurate information the first time. Please do the following when submitting your application:
- Check all applicable boxes and provide effective dates where needed
- Include a copy of IRS documentation as proof of Tax Identification Number (i.e., CP-575 or any legal document from the IRS showing the name and TIN)
- All Legal Business Names on NPI statements should match your IRS Documents exactly including spaces and abbreviations.
- Sign and date all applications. Original signatures are required on each application
- Include a copy of all applicable state licenses
Note: Failure to provide all of the necessary information and/or documentation may cause your application to be returned to you for completion.
Call our Provider Enrollment staff at 1-866-734-9444 and ask for Provider Enrollment Send your completed application, including original signatures, to:
Provider Enrollment A
WPS Medicare
Medicare Provider Enrollment
PO Box 1604
Omaha, NE 68101
- CMS 855A Attachment Questions
- CMS 855A Application Completion/Submission Questions
- National Provider Identifier (NPI) Questions
For more information on National Provider Identifier (NPI), please visit our web-site at: http://www.wpsmedicare.com
CMS FAQ for Provider Enrollment
Financial Area - Electronic Funds Transfer Information
Page Last Updated: Thursday, 18-Mar-2010 05:48:16 CDT
