| Word/Phrase | Definition |
| Authorized Official |
An appointed official to whom the supplier has granted the legal authority to enroll it in the Medicare program to make changes and /or updates to the supplier's status in the Medicare program (e.g., new practice locations, change of address, etc.) and to commit the supplier to fully abide by the laws, regulations and program instructions of Medicare. |
| Provider |
A provider is a hospital, critical access hospital, skilled nursing facility, nursing facility, comprehensive outpatient rehabilitation facility, home health agency or hospice that has in effect an agreement to participate in Medicare. A provider is not synonymous with the corporation or legal entity that owns or operates the provider. The 'provider' is the CMS recognize provider type listed above. Therefore, an owning or operating entity may own or operate many providers. |
| Supplier |
A supplier is a physician or other practitioner, or an organization other than a provider that furnishes health care services under Medicare Part B. The term supplier also includes independent laboratories, portable x-ray services, physical therapists in private practice, end stage renal disease (ESRD) facilities and chiropractors. For enrollment purposes, suppliers that submit claims for durable medical equipment, prosthetics, orthotics or supplies (DMEPOS) must complete the CMS 855S. The application (CMS 855B) is not for DMEPOS suppliers. |
| Delegated Official |
Any individual who has been delegated by the supplier's 'Authorized Official' the authority to report changes and updates to the supplier's enrollment record. A delegated official must be a managing employee (W-2) of the supplier or have 5% ownership interest, or any partnership interest, in the supplier. |
| PTAN |
The Provider Transaction Access Number (PTAN), formerly known as the Provider Identification Number (PIN), is assigned to providers, suppliers, groups or organizations, and individuals who submit claims to Medicare B. |
| Reactivation |
If the supplier's Medicare billing number was deactivated because of non-billing. Billing privileges may be deactivated when Medicare has not received claims in a twelve-month period after the enrollment has been approved. To reactivate billing privileges, the supplier may be required to either submit an updated CMS 855B or certify to the accuracy of its enrollment information currently on file with CMS. In addition, prior to being reactivated, the supplier must be able to submit a valid claim. It must also meet all current requirements for its supplier type, regardless of whether it was previously enrolled in the program. |