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Medicare Revalidations Made Easy


Medicare Revalidations Made Easy

By: Ramesh Leelasankar, Revenue Cycle Management Manager

Have you ever been shocked with countless Medicare denials deemed as “provider not certified?” If you answered yes, don’t feel discouraged. It happens to every medical provider, group and supplier at some point in practice history.

For some, it takes an extended period of time to realize that the denial is because of missing a Medicare revalidation date. For others, it is a daunting task to regroup all documents and complete the appropriate enrollment application within the given timeframe.

After completing the enrollment process and getting your Medicare provider number re-activated, you may wonder:

“Do I immediately get the next due date of revalidating my Medicare provider number again?”

The unfortunate answer is no. So, when and how do you get informed about these dates going forward? Revalidation notices are sent to your email, special payment address and correspondence address within two to three months of your due date. If you’re worried about missing the alerts, check out our tips:

-Perform a monthly check in the following “Medicare Provider Number Lookup Tool.” If your search returns a due date, complete your CMS 855 paper application or PECOS electronic application two months prior to the due date. If the provider search returns “TBD,” no action is needed for six months.

-If you are part of a large practice and would like to know the revalidation dates of your group providers, use the “Group Practice Members only” option in the previous link. Our team can provide more detailed instructions on search, filter and download options.

For further guidance, Medicare provides a revalidation checklist, but it is pertinent to pay close attention to minute details. Small mistakes in punctuation, spacing and signatures might differentiate NPPES records with IRS records, and could lead Medicare to reject your enrollment applications.

MA Revalidation

Even with all of these resources, it is common for providers to miss revalidation due to lack of process knowledge or repetitious forms. At Saisystems Health, we’ve come to find that processing enrollment applications and getting them approved on the first attempt requires a specialist’s attention; our attention. We can assist your practice with:

    1. Automatically tracking your due date in our system

    2. Alerting you in time to provide our team with necessary paperwork for completion

    3. Completing the electronic or paper application

    4. Monitoring application status

    5. Confirming acceptance with Medicare through letter correspondence

Let us be the specialist for you! Our expert credentialing team has Medicare application turnaround times of less than a day, and proven success in revalidating enrollment applications on the first attempt. If you would like assistance with your revalidations, contact our sales representative, Sam, at smanns@health.saisystems.com or call 203-567-5260 to get started!