Credentialing Changes: Submit Updated Information Timely
Published 12/31/2020
When there is a change in your practice or facility that affects your credentialing information on file with Palmetto GBA, it is important that you submit updated information. Use this checklist to ensure that your changes are submitted on time.
These timeframes apply to:
- Physicians
- Nonphysician practitioners
- Physician and nonphysician practitioner organizations
- Independent Diagnostic Testing Facilities (IDTFs)
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What
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When
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|---|---|
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Change of ownership or control
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Within 30 days of the change
|
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Change in practice location
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Within 30 days of the change
|
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Final adverse action
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Within 30 days of the change
|
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All other changes
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Within 90 days of the change
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Submit changes by completing the appropriate sections of the CMS-855 application, using PECOS or a paper application.
- Changes for individual providers: submit an updated CMS-855I application
- Changes for sole-owned groups: submit an updated CMS-855I application
- Changes for provider groups: submit an updated CMS-855B application
- Changes in reassignment of individual provider payments to a provider group: submit an updated CMS-855R application
- IDTFs: submit an updated CMS-855B application
References
- CMS Medicare Provider Enrollment Publication
- Internet-based PECOS