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Printed Date: 9/22/2015
On the CMS-855B Enrollment Application, the address sections are:
NOTE: It is vitally important that providers pick the correct address for appeals correspondence. Appeal letters include private information about Medicare beneficiaries. It is considered a Protected Health Information (PHI) violation if the letter is returned by someone because it went to the wrong address. Providers should ensure that the address they choose (pay-to address or practice address) is the correct one for handling appeal decisions. Providers can choose to receive letters via eServices. This prevents PHI exposure.
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Last Updated: 08/27/2018