Provider Enrollment - JE Part B
For In-Depth Provider Enrollment Information
Provider enrollment regulations can be reviewed in:
CMS Internet Only Manual (IOM), Publication 100-08, Medicare Program Integrity Manual, Chapter 10 .
Total Enrollment: Provider Enrollment
Providers and suppliers enroll in the Medicare program to receive reimbursement for services rendered to Medicare beneficiaries. The following steps outline the process of enrolling in the Medicare program. Additional information is available on Noridian's Enrollment on Demand (EoD) Tutorials for Part B Specialties webpage.
Step 1: Obtain a National Provider Identifier (NPI)
Create an account for NPPES using the Identity & Access (I&A) Management System. Only one account is needed to access PECOS, EHR, and NPPES.
After establishing the log on at I&A, apply for a National Provider Identifier (NPI) at the National Plan and Provider Enumeration System (NPPES).
The appropriate types of NPIs include:
- Type 1 for individuals
- Type 2 for organizations
Step 2: Application Preparation
Review the provider's enrollment documentation to ensure submission of the correct application. Applications can be completed in two ways:
- Complete an electronic application with the Provider Enrollment, Chain and Ownership System (PECOS), by logging in to the PECOS website with the same username and password created at I&A.
- Complete an appropriate paper application from Noridian's Forms page.
Step 3: Supporting Documentation
Required supporting documents depend on the enrollment scenario. The most common documents include:
- IRS documentation such as a CP575 notice or LTR147C
- CMS 588 Electronic Funds Transfer (EFT) agreement
- Voided check or bank verification letter
- CMS 460 Participation Agreement
- Diploma, national certification
Step 4: Application Submission
PECOS web applications are submitted electronically with the supporting documents uploaded. Documentation cannot be mailed for PECOS applications. Once the application is submitted, PECOS issues a submission receipt showing the web tracking number.
Paper applications, along with the supporting documentation, must be sent to Noridian's Mailing Addresses. Once the application is received, providers will be sent an acknowledgment letter showing their application reference number.
Step 5: Check Application Status
Using the application reference number or web tracking number, the status of the application can be verified on Noridian's Enrollment Application Status Search. Application timeframes can be found on Noridian's Enroll in Medicare page.
Step 6: Application Complete:
Once Noridian has processed your application, a notification letter is emailed to the contact(s) reported in the application. Approval letters are not mailed except under extenuating circumstances. Part A suppliers require a tie-in notice from CMS for final approval of the enrollment. After receiving the notification approval letter, Register for Electronic Data Interchange (EDI).
