Are You Submitting a Handwritten Medicare Enrollment Application?

Medicare enrollment application forms are fillable on your computer. This means that you can fill out the information required by typing into the open fields while the form is displayed on your computer monitor. Filling out the forms this way before printing, signing and mailing means more easily-readable information – which means fewer mistakes, questions, and delays when your application is processed. Be sure to make a copy of the signed form for your records before mailing.

 

You’ll find the Medicare provider enrollment application forms available on the CMS website:

• CMS 855A – Application for Institutional Providers
• CMS 855B – Application for Clinics, Group Practices, and Certain Other Suppliers
• CMS 855I – Application for Physicians and Non-Physician Practitioners
• CMS 855R – Application for Reassignment of Medicare Benefits
• CMS 855S – Application for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers

Signatures are still required to be handwritten. Don’t forget to complete this important step prior to mailing your typed form(s).

 

Keep in mind that typed forms are easier for Medicare to process, but the most efficient method for submitting your enrollment application is to use the Internet –Based Provider Enrollment, Chain and Ownership System (PECOS). PECOS guides you through the enrollment application so you only supply information relevant to your application. PECOS also reduces the need for follow-up because of incomplete applications. Using Internet-based PECOS results in a more accurate application and saves you time and administrative costs. Visit Internet-Based PECOS to learn more.