Medicare PTAN Number Could be Deactivated

Date:   10/30/2008

Providers who do not submit a valid Medicare claim in a 12-month period risk deactivation of their Medicare PTAN number. To reactivate your PTAN number, you will be required to complete the appropriate CMS-855 enrollment application for your provider type. Make sure you are ready to submit claims to Medicare before submitting a new CMS-855.

CMS has also mandated that all new Medicare enrollees must agree to accept Medicare claims payment via electronic funds transfer. CMS has also mandated that current enrolled providers must agree to accept EFT at the time of any change in their enrollment records or change in their enrollment status. Provider will need to complete a CMS-588 Electronic Funds Transfer Agreement with enrollment application.

Current forms can be downloaded from the CMS Web site at:

CMS-855A (Institutional Providers) -
http://www.cms.hhs.gov/cmsforms/downloads/cms855a.pdf

CMS-855B (Clinics/Group Practices and Certain Other Suppliers) -
http://www.cms.hhs.gov/CMSforms/downloads/cms855b.pdf

CMS-855I (Physicians and Non-Physician Practitioners) -
http://www.cms.hhs.gov/cmsforms/downloads/cms855i.pdf

CMS-855R (Reassignment of Medicare Benefits) -
http://www.cms.hhs.gov/cmsforms/downloads/cms855r.pdf

CMS-588 (Electronic Funds Transfer Agreement)
http://www.cms.hhs.gov/CMSForms/downloads/CMS588.pdf

Provider Action:

Please contact your local Medicare contractor for further details.