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CMS announces new enrollment form for referring/ordering dentists

Washington—Administration officials Aug. 23 announced approval of a simplified form for dentists and other health care providers enrolling in Medicare for the sole purpose of ordering Medicare-covered items or referring Medicare patients for covered services.

The Association had urged the Centers for Medicare & Medicaid Services to offer a simplified enrollment process for ordering/referring dentists not enrolled in the Medicare program. CMS officials subsequently identified an abbreviated process for dentists and submitted revised enrollment forms for White House Office of Management and Budget approval.

The OMB recently approved the new CMS 855O application form used for the sole purpose of enrolling to order and refer items and/or services to Medicare beneficiaries. The form is entitled “Medicare Enrollment Application For Eligible Ordering and Referring Physicians and Non-Physician Practitioners.” The OMB also approved changes to the other Medicare Provider-Supplier Enrollment Applications to update them from 2008 versions, CMS said.

The abbreviated process does not apply to dentists already enrolled to provide Medicare services or enrolling for the purpose of submitting claims.

Providers and suppliers using other CMS-855 forms to enroll in Medicare are encouraged to begin using the revised forms but may use the old forms through October, 2011.

CMS has not issued a final regulation on enrollment for ordering/referring purposes and has not activated automatic edits that will reject Medicare claims if the ordering/referring provider or supplier is not enrolled in Medicare’s Internet-based Provider, Enrollment, Chain and Ownership System (PECOS).

CMS is not currently rejecting claims for items and services referred or ordered by providers or suppliers without a PECOS record. The agency said it will give ample notice before claim rejections begin.

CMS established the Internet-based PECOS as an alternative to the paper (CMS-855) enrollment process. Internet-based PECOS allows physicians, non-physician practitioners and provider and supplier organizations to enroll, make a change in their Medicare enrollment, view their Medicare enrollment information on file with Medicare, or check on status of a Medicare enrollment application via the Internet.