Medicare requires that you complete specific forms issued by CMS when you apply to become a Medicare provider. Sounds easy enough, but have you seen the list of forms they have? How are you supposed to know the right form to fill out and once you figure it out, which form fields to fill out?
If you are an independent provider, can you bill with a tax identification number (EIN number) or do you have to use your social security number? Is it necessary if you use a tax identification number to apply for a Medicare group number? And why would you have to reassign the benefits to yourself?
Well, it’s actually not as complicated as it seems. If you are a sole provider and are using your social security number for your tax identification number, you must complete an 855I, 588 EFT, and a CMS 460. The CMS 460 is the participating provider agreement. You only need to complete this if you choose to be a Medicare participating provider. The 588 EFT is the electronic funds transfer form. Medicare requires that you accept EFT and they will transfer your payments directly to your bank account. The 855I is the single vendor application.
If you are an individual provider who will be billing with a tax identification number but you are a sole proprietor, you will also need to complete the 855I, 588 EFT and the CMS 460.
When applying for a group, you will need to complete an 855B, an 855I for each provider in the group, an 855R for each provider in the group, a 588 EFT and a CMS 460. The 855B is the group application and the 855R is to reassign benefits for each supplier to the group. If you are an individual provider but have formed a corporation, you must apply for a group application for the corporation.
Forms are available online. You must complete the appropriate forms and submit them to the Medicare company in your area. It is crucial that you complete the forms correctly to avoid delays. If your application is not complete or correct, the carrier will ask you for the additional or corrected information. If you do not respond or do not respond in time, your request may be closed.