Are You Submitting a Handwritten Medicare Enrollment Application? Medicare enrollment application forms are fillable on your computer. This means that you can fill out the information required by typing into the open fields while the form is displayed on your computer monitor. Filling out the forms this way before printing, signing and mailing means more easily-readable information - which means fewer mistakes, questions, and delays when your application is processed. Be sure to make a copy of the signed form for your records before mailing.
You'll find the Medicare provider enrollment application forms available on the CMS website<https://www.cms.gov/MedicareProviderSupEnroll/02_EnrollmentApplications.asp>: § CMS 855A - Application for Institutional Providers<https://www.cms.gov/CMSForms/CMSForms/itemdetail.asp?itemID=CMS019475> § CMS 855B - Application for Clinics, Group Practices, and Certain Other Suppliers<https://www.cms.gov/CMSForms/CMSForms/itemdetail.asp?itemID=CMS019476> § CMS 855I - Application for Physicians and Non-Physician Practitioners<https://www.cms.gov/CMSForms/CMSForms/itemdetail.asp?itemID=CMS019477> § CMS 855R - Application for Reassignment of Medicare Benefits<https://www.cms.gov/CMSForms/CMSForms/itemdetail.asp?itemID=CMS019478> § CMS 855S - Application for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers<https://www.cms.gov/CMSForms/CMSForms/itemdetail.asp?itemID=CMS019480> Signatures are still required to be handwritten. Don't forget to complete this important step prior to mailing your typed form(s). Keep in mind that typed forms are easier for Medicare to process, but the most efficient method for submitting your enrollment application is to use the Internet -Based Provider Enrollment, Chain and Ownership System (PECOS). PECOS guides you through the enrollment application so you only supply information relevant to your application. PECOS also reduces the need for follow-up because of incomplete applications. Using Internet-based PECOS results in a more accurate application and saves you time and administrative costs. Visit Internet-Based PECOS<http://www.cms.gov/MedicareProviderSupEnroll/04_InternetbasedPECOS.asp#TopOfPage> to learn more. Note: If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser. If you know someone who would like to subscribe to a Medicare Fee-For-Service (FFS) provider listserv, go to (http://www.cms.gov/prospmedicarefeesvcpmtgen/downloads/Provider_Listservs.pdf). If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/wa.exe?INDEX) to unsubscribe or to leave the appropriate listserv. Please DO NOT respond to this email. This email is a service of CMS and routed through an electronic mail server to communicate Medicare policy and operational changes and/or updates. Responses to this email are not routed to CMS personnel. Inquiries may be sent by going to (http://www.cms.gov/ContactCMS). Thank you.
