CMS requires users to change their passwords every 60 days, and encourages users to take the certain additional actions to help protect their Medicare enrollment information. See Safeguard Your Identity and Privacy Using PECOS (PDF).
I’ve heard that CMS will use site visits as a screening activity to make sure only qualified providers and suppliers are enrolled. If I enroll in Medicare, could I be subject to a site visit?
According to CMS, a dentist who enrolls only to order imaging, clinical laboratory and DMEPOS (i.e., using form CMS 855-O) will not be subject to such a site visit. However, a dentist who enrolls to bill Medicare (i.e., using form CMS 855-I) may be receive such a site visit. In other words, the site visits are only performed on billing providers. Providers that are enrolled solely to order and prescribe are not subject to these visits.
The purpose of the site visit is to determine that the location identified by a provider on his or her application is open and operational. CMS will utilize its National Site Visit Contractor to perform these site visits. Results of the site visits are transmitted to CMS/MAC (Medicare Administrative Contractor) to take the appropriate action if the location is found to be non-operational (e.g., deactivation or revocation).
CMS announced in February, 2016 that increasing the number of such site visits is one of four tactics to reinforce screening activities aimed at protecting the integrity of the Medicare program and making sure only qualified providers and suppliers are enrolled. For more information, visit CMS, Strengthening Provider and Supplier Enrollment Screening, and CMS strengthens provider and supplier enrollment screening.
I’ve heard that CMS will deactivate the enrollment of certain providers who have not billed Medicare in the last 13 months. Does this apply to dentists?
Dentists should not be subject to deactivation for failure to bill, whether they enroll to bill Medicare (i.e., using form CMS 855-I) using or just to order and prescribe (i.e., using form CMS 855-O).