How to Obtain a CMS Certification Number

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If your organisation is providing medical care for patients it's incredibly important that you have a CMS Certification Number. Medicare may be available to cover the costs of your operations, such as if you’re providing care to those over 65. The CMS Certification Number application process is simple once you know what you're doing and the various websites associated with CMS and Medicare hold plenty of FAQ's the answer any questions. [1]

Part 1
Part 1 of 3:

Finding the Correct Form

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  1. You can find all the resources needed to obtain your CMS Certification Number at this link: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/EnrollmentApplications.html .
    • There are several different forms on this page, one of which you'll need to submit depending on your requirements.
  2. Most hospitals, hospices and skilled nursing facilities come under the definition of an institutional provider, but there are many more detailed in the first pages of the form.
    • CMS-855A is widely encompassing, so if none of the other forms apply to you, make sure to check this one.
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  3. Clinics or group practices that provide Part B Medicare to their patients fall under this bracket as well as vendors of Part B drugs, X-Ray suppliers or an ambulance service provider. [2]
  4. Many private physicians or consultants fall under this category such as physical therapists, clinical social workers or registered nutrition professionals.
  5. Reassigning your Medicare benefits allows certain eligible groups or organizations to submit claims and payments for Part B Medicare services that they have provided as members of these groups.
    • This form works for individuals, small groups, or entire organizations.
  6. Under the Affordable Care Act specific drugs that fall under Part D of Medicare can now only be ordered by those who have submitted this form. [3]
    • Retired physicians, dentists or those part of a medical residency program are all effected and should complete this form.
  7. This form can apply to a wide range of potential applicants.
    • Local pharmacies, grocery stores, hospitals and therapists all need to complete this form if they sell such equipment.
  8. If you supply any materials to help this program or want to facilitate the program itself this form needs to be completed first.
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Part 2
Part 2 of 3:

Completing the CMS Form

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  1. The process for getting a new CMS Certification Number usually requires many legal documents. Before you begin, make sure you know where to find all legal documentation of your organization so that you can avoid delays during the application process.
    • Now is a good time to sort through your file cabinets and retrieve any documents that haven't been looked at in a long time.
  2. The application forms can be dense meaning they require concentrated reading. Before you write anything on it, read through it carefully to make sure that you are ready to apply. Often the language used is not particularly readable so it's best to read slow and careful to make sure you aren't missing anything.
    • This is especially true if you have any conditions that impair reading ability. [4]
  3. Each form is slightly different from each other so no all encompassing advice can account for all the forms. However, there are similarities to look out for in each of them.
    • Each form will start with a section called "Who Should Complete This Application". If you are unsure whether a particular form applies to you, read this section carefully and it may resolve any lingering doubts.
    • Although the forms are long, depending on what boxes you tick in the opening pages can change how much of the form you need to complete. Much like a choose-your-own-adventure book, these boxes will direct you to specific sections of the form that apply to you meaning you waste less time completing irrelevant parts.
    • Most of the forms require different information from you, but they have several shared characteristics such as the legal name of your organisation, specific high level staff, tax identification number, address information, state license number and medicare identification number if you already have one.
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Part 3
Part 3 of 3:

Sending Away Your Form

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  1. If you have completed the form as a pdf file you will need to print it out. Make sure you print if from a good quality printer so that the ink contrast is strong and place it in a neat pile.
  2. At the end of the form you will be asked to attach documentation to support your application. Much of this is to insure that you are a legitimate care organisation. Take your time in finding this documentation because if it is not exactly what they are looking for your CMS Certification Number Application may be rejected.
  3. Your governmental representative is usually your local Medicare Administrative Contractor or your legacy Fiscal Intermediary.
    • If you are unsure who they are, use a search engine to find their contact information and they will be more than happy to help your application process. [5]
  4. Once you have sent off your application it may take a while for the process to be reviewed. Once your regional representatives have approved it they will send you a survey to complete, after which you should be in possession of your CMS Certification Number.
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      Tips

      • Don't rush the application process. They are long documents and if you become tired you may start making mistakes. If possible, break up the completion and reading process into several different sessions.
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      Warnings

      • If your organisation has changed its type of care (e.g from short term acute care to Long Term Care) then your CMS Certification Number will have changed already.
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      References

      1. ↑ https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/FAQ.html
      2. ↑ https://www.medicare.gov/what-medicare-covers/part-b/what-medicare-part-b-covers.html
      3. ↑ https://www.aarp.org/health/medicare-insurance/info-11-2009/how_medicare-part_d_drug_coverage_works.html
      4. ↑ https://www.w3.org/TR/UNDERSTANDING-WCAG20/meaning-supplements.html
      5. ↑ https://www.cms.gov/Medicare/Medicare-Contracting/Medicare-Administrative-Contractors/What-is-a-MAC.html

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