Provider Enrollment: Completing the CMS 855A

This is a recording of the webinar held on 05/22/2024. This session intended those responsible for credentialing facilities that will bill Medicare Part A using the UB-04 claim form or 837I electronic transaction. It provides information on the CMS 855A including: • Accessing the CMS 855A both electronically and on paper • Completing the CMS 855A for facilities and institutions • Making changes to existing information using the CMS 855A Resources: CMS 855A Application: https://www.cms.gov/medicare/cms-forms/cms-forms/cms-forms-items/cms019475 Medicare Program Integrity Manual (PIM) Chapter 10 § 10.2.1: https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/pim83c10.pdf Code of Federal Regulations (CFR) 424.67(b)(1)(i) Enrollment requirements for opioid treatment programs (OTP): https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-424/subpart-E/section-424.67 Chapters 00:00 Intro 02:27 Overview 05:32 Submission Options 09:01 Completing the Application - Section 1 13:47 Completing the Application - Section 2 28:16 Completing the Application - Section 3 31:23 Completing the Application - Section 4 37:21 Completing the Application - Section 5 42:12 Completing the Application - Section 6 43:42 Completing the Application - Section 8 44:21 Completing the Application - Section 10 46:23 Completing the Application - Section 12 47:14 Completing the Application - Section 13 38:40 Completing the Application - Section 15 50:50 Documentation 53:15 Resources 54:08 Questions 58:42 Closing Comments