Anyway if we go to slide to there's a little disclaimer there now we are going into a technically complicated area and in in some sense the your signs of success will be getting people in rules now 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 at least for the hospital itself doesn't have that many 855 forms okay I've been a 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 want to form when you switch over to clinics and hospitals now more and more have clinics provider-based clinics sometimes they're freestanding clinics we also employ mid-levels they're doing various things so we're doing a lot of different things and in so doing you're going to need to have multiple resources that say the same thing and so 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 and say the same thing now many of you who have worked with medicare over the years realize that getting to different resources for medicare to say the same thing it can be a bit of a challenge even in and of itself slide that three please go to slide three well if you wish you can read about me ah most of you i'm going to guess have been in previous workshops of some sort some place some time and I travel I consults I audits I prtestimony in court all of these things and so I have a fairly wide background...
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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, 2022 — 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, 2022 — 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, 2022 — CMS-857-S Form — Palmetto GBA for DM EPOS Suppliers. For additional information regarding the Medicare enrollment Forms — CMS Dec 1, 2022 — 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, 2022 — 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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