Anyway, if we go to slide two, there's a little disclaimer. Now, we are going into a technically complicated area and, in some sense, the signs of success will be getting people in roles. We have a lot of problems with enrollment. I'm going to be talking about hospitals, which are a little easier. Hospitals don't have that many 855 forms. Okay, I've been in very large hospitals that had precisely one form, and I got to be kind of long in some sense. I mean, there's a lot of information in there, but it had exactly one form. When you switch over to clinics and hospitals, more and more have clinics, provider-based clinics. Sometimes they're freestanding clinics. We also employ mid-levels who are doing various things, so we're doing a lot of different things. In doing so, you're going to need to have multiple resources that say the same thing. This disclaimer basically says, "Hey, look, I'm going to give you the very best I have today, but when push comes to shove, you need to get to other resources that say the same thing." Many of you who have worked with Medicare over the years realize that getting to different resources for Medicare to say the same thing can be a bit of a challenge, even in and of itself. Go to slide three, please. Well, if you wish, you can read about me. Most of you, I'm going to guess, have been in previous workshops of some sort, some place, sometime. And I travel, consult, audit, provide testimony in court - all of these things. So, I have a fairly wide background, which by the way is needed when we go to these 855 forms. Now, one of the challenges - there are several challenges - but...
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CMS-857-S. Form # (PDF) CMS 857S (PDF). Form Title. CMS 857S. Form Number. Medicare Enrollment Application — Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DM EPOS) Suppliers. Medicare ENROLLMENT APPLICATION — Primary Billing Submit this application with your application to request a primary Medicare bill. Dec 1, 2024 — The following forms can be used for initial enrollment, revalidations, CMS-855S for DM EPOS Suppliers; CMS-20134 (PDF) for MPP Suppliers. NSC — CMS 857-S Form — Palmetto GBA Apr 13, 2024 — Applicable CARS/DEARS restrictions apply to government use. U.S. Government Rights. This product includes CPT which is commercial technical data MEDICARE ENROLLMENT APPLICATION — Primary Billing Complete this application if you plan to bill Medicare for DM EPOS and you are: The applicant completes and submits an enrollment application (CMS-855S) Nov 2, 2024 — CMS-857-S Form — Palmetto GBA for DM EPOS Suppliers. For additional information regarding the Medicare enrollment Forms — CMS Dec 1, 2024 — The following forms are available for revalidations of an enrollment application (not to be used if revalidating for DM EPOS). CMS-852-S. Form # (PDF) Medicare Enrollment Application — (PDF) MEDICARE ENROLLMENT APPLICATION — (PDF) Medicare Enrollment Application — (HST-MISC-853) Dec 1, 2024 — The following forms can be used for initial enrollment, revalidations, CMS-855S for DM EPOS Suppliers; CMS-20134 (PDF) for MPP Suppliers. CMS-852-S Form — (PDF) CMS-852-S. Form # (HST-MISC-835) Jan 2, 2042 — The following forms must be submitted to Medicare during the year a primary bill is processed and Medicare is unable to process a payment. They are no longer available for use.
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