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Revalidation Of Providers

CMS has taken the steps to clarify revalidation process of healthcare providers who have registered in the Medicare program. According to sources privy to the organization, CMS is very strict in identifying the genuine healthcare providers.

As part of the revalidation process, the CMS conducted a conference call on 1st March. During this conference call, new information and guidelines regarding the Medicare programs were presented to the participants. During the conference call, participants were also allowed to air their questions about the revalidation process, and they were clarified on the spot.

As per the Affordable Care Act (ACA), all enrolled healthcare providers and suppliers are supposed to revalidate their Medicare enrollment information. The revalidation will be executed under the new screening criteria. The preliminary rounds of validation have already been completed. CMS said that it will resume the regular rounds revalidation cycles for all the enrolled providers.

Once in every five years, all the enrolled providers are supposed to be validated. Regular revalidation rounds for enrolled providers are conducted through the Provider Enrollment, Chain and Ownership System (PECOS). A special team appointed by CMS will notify the providers about the regular revalidation once it is due.

What Are Areas Checked During The Revalidation Process?

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Medicare Administrative Contractors

CMS’s revalidation process will focus on a number of areas, from active practice locations to current reassignments. During the conference call, CMS emphasized on the new lookup tool that it has developed for the healthcare provider. With the help of this new lookup tool, the providers and their representatives can search individual healthcare providers or the organizations.

You need to do the search using the Last Name, First Name, NPI or Organization Name. When the search is completed, the lookup tool will only display the list of providers that need to revalidate themselves in the next six months. Providers are supposed to undergo the revalidation which gets due on the last day of the specified month.

Although revalidation in once in five years is a must, CMS says it won’t approve it if requested more than six months in advance. Besides the lookup tool, the Medicare Administrative Contractors (MAC) would send notices to providers via email before the deadline. This helps the providers to know in time that their due date for the revalidation has arrived. Healthcare providers are supposed to produce the letter or email notification they received from MAC while appearing for revalidation.