Medicare Provider Re-validation: Update Your Enrollment to Avoid Payment Delays!

July 11, 2016

The Centers for Medicare & Medicaid Services has begun a provider re-validation process to identify and update changes that have occurred since the provider’s original enrollment.  This process includes both institutional providers, such as hospitals, and individual providers. The re-validation process is being conducted by the Medicare Administrative Contractors on a rolling basis due to the number of providers involved.  Providers must complete the re-validation process within six months of their assigned due date to avoid delays or gaps in Medicare payment.

Noridian, our local Medicare Administrative Contractor, reports that a large proportion of providers already assigned due dates have not yet responded to re-validation requests and requested WSHA’s help to get the word out. Noridian is notifying providers of their re-validation due date via email and USPS mail based on the contact information they have on file. This may be problematic for providers who have had staffing changes since their original enrollment.

Hospitals and other providers can check the CMS database at https://data.cms.gov/revalidation to determine if they have been assigned a re-validation due date. Unfortunately, there is no mechanism for a provider to complete the re-validation process before a due date is assigned.

Additional information and instructions related to re-validations can be found on Noridian’s home page at https://med.noridianmedicare.com/web/jfa/enrollment/revalidation. (Andrew Busz, andrewb@wsha.org)

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