CMS has defined time frame for providers and suppliers to send their re-validation application to the Medicare Administrative Contractors (MAC) to be in compliance with provider enrollment requirements. The due dates generally fall on the last day of the month, for example, 30th June, 31st July which is determined based on the last successful re-validation or initial enrollment date. The provider/Supplier may experience hold in reimbursement and even lose their billing privileges if the re-validation application is not sent within the specified time frame.
It is good that the contact person nominated by the provider will also be receiving the re-validation notice via email or regular mail. Re-validation period is around 3 years for DME suppliers and 5 years for all other provider and suppliers.
The following web address http://go.cms.gov/MedicareRevalidation will
be very useful in obtaining the list of all enrolled provider and suppliers. The ones which are due for re-validation will be indicated with a re-validation date and all others who are not up for re-validation will be displayed as “TBD”. TBD stands for “to be determined, which will be indicated in the Due date field.
CMS encourages the providers and suppliers who are within 2 months of the listed due dates in the website given above to submit their application for re-validation even if they have not received a notice from their Medicare administrative contractors to re-validate.
PECOS which stands for Provider Enrollment Chain and Ownership system happens to be very helpful. This internet based application aids faster and effective process for submitting the information for re-validating.
The following table can be used as guide to understand the order of events through the re-validation progression
| Action | Time frame | Example Due Date |
| MAC sends email/letter notification/ letter for undeliverable emails | 75 – 90 days prior to due date | July 2 – 17, 2016 |
| Re-validation due date | By Due date | Sep-30-16 |
| Apply payment hold/issue reminder letter | Within 25 days after due date | Oct-25-16 |
| Deactivate | 60 – 75 days after due date | November 29 – December 14, 2016 |
It is important that the re-validation application should be sent with completed information. Medicare Administrative Contractors would still request for the missing information with a turnaround time of 30 days from the date of request, failing to do so may result in provider/Supplier losing their billing privileges.
e-care has a strong Credentialing department which is fully geared up in meeting the requirements of CMS in getting the providers re-validated/re-credentialed so that they do not lose their billing privileges. For more details write to info@ecareindia.com or call at 813-666-0028