The old form may not be binding after March 1, 2009.  Beginning March 1, 2009, Medicare contractors will accept only a properly executed revised advance beneficiary notice of non-coverage (CMS R-131) as a valid notification. 

Are you one of them?  Medicare provider enrollment rules and procedures have changed significantly over the last few years. Are you are one of those lucky providers who moved through this without any problems?  If so, you may be most likely to get caught in the automatic deactivation of your Medicare enrollment.  

We have received current contact information for First Coast Service Options (FCSO).

Following are several updates from the Medicare Learning Network, which include downloadable resources, to help you better navigate your way through Medicare claims.

New Enrollment Fact Sheets from the Medicare Learning Network.

First Coast Service Options has released information on how to qualify for the 2011 EHR incentives.

Many chiropractors are receiving a report from Medicare that tells them how they compare to their state and national colleagues.

While Medicare Advantage (also known as Part C) plans are NOT regulated or governed by ERISA, there are similar appeal protections.  CMS governs and monitors MA plans, and sets the policies that MA plans must follow. MA plans have contracts with CMS to provide insurance to beneficiaries and CMS pays MA plans to provide those services.   Therefore, the appeals process for MA plans is dictated by CMS. 

Health care providers who find themselves or their practices not listed in the Physician Compare directory on medicare.gov may need to update their enrollment information in PECOS (Provider Enrollment Chain and Ownership System).   This can be done by submitting the appropriate paper form or using Internet based PECOS.

If health care professionals have not sent in a Medicare application to report any changes to their Medicare enrollment information since November 2003, they may not have enrollment records in PECOS.  These individuals will need to submit an initial Medicare enrollment application.

First Coast Service Options, Inc. (FCSO) will provide to you, upon request, a provider billing report that can be used to identify personal billing patterns in comparison with those of your peers. By identifying a potential billing issue in one month and taking action to prevent the issue in the future, you can create a more satisfying and efficient Medicare billing process.  Your administrative costs are increased whenever bills must be rebilled, reposted and analyzed to figure out what you are doing wrong.