Experience. Integrity. Advocacy.
Experience. Integrity. Advocacy.

Medicare Revalidation: What To Do with That Yellow Envelope

That yellow envelope you just received from your Medicare Administrative Contractor (MAC) could mean the difference between uninterrupted payments for your practice or missed revenue and cash flow problems.

The Centers for Medicare and Medicaid Services is more than a year into their massive revalidation process, in which all 1.5 million providers and supplied enrolled with Medicare as of March 25, 2011, will be revalidated prior to March 25, 2015.

If you have received a revalidation notice, you must resubmit Medicare enrollment forms – either on PECOS (Provider Enrollment, Chain and Ownership System) or by paper 855 forms– and any supporting documents to your MAC within 60 days of the postmark on the letter.

To better serve Medicare providers, several provisions were made for this massive revalidation process. According to Mark Majestic of CMS’s Provider Enrollment Operations Group, MACs are sending letters both to the physical and correspondence addresses on file, and will also make two telephone calls to try to alert providers that it is their turn for validation. Also, the MACs will not require valid documents already on file to be resubmitted, and supporting documents that are required will be accepted by fax, email, or regular mail.

Most significantly, if a provider does not respond to the revalidation process within 60 days – for any reason – their Medicare enrollment will be deactivated rather than revoked, which means that to be reinstated, providers simply need to submit their revalidation documents rather than a complete re-enrollment.

“It will not be an adverse action again them,” Majestic said in an October 10, 2012, National Provider Call.

To avoid processing issues and backlogs, MACs will not accept “spontaneous or unprompted revalidations,” Majestic noted in the call. Providers must wait until they receive the revalidation letter before they can begin the process. The first letters were sent out in Fall 2011 and continue to be issued on a regular basis; lists of all providers to whom letters have been sent so far are available on the CMS website.

Also, providers who receive a letter but do not feel they can complete the revalidation prior to the 60 days after the postmark can contact their MAC for a possible extension.

“There are a number of reasons why somebody would request [an extension], and they are too numerous to mention” Majestic said. “But each of those extension requests is reviewed by the MAC and subsequently, they’ll be addressed. And there have been many thousands of providers/suppliers who have successfully requested an extension that has been granted by the MAC.”

For additional information on the Medicare Revalidation Process, visit the Revalidations pageof the CMS.gov website or review the presentation or transcript from the October 10, 2012, National Provider Call.

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Charity Singleton Craig

Charity Singleton Craig is a freelance writer and editor who provides communications and marketing services for CIPROMS. She is responsible for creating, editing, and managing all content, design, and interaction on the company website and social media channels in order to promote CIPROMS as a thought leader in healthcare billing and management.

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