Top Reasons for Enrollment Delays

  • Section 2B 1of CMS-855A must reflect Legal Business Name as it appears on IRS document
  • Section 4A of CMS-855A should reflect last four digits of zip code for provider
  • If a hospital has more than one practice location listed in section 4A of CMS-855A, provider should indicate type for other locations listed
  • At least one individual must be marked as a managing employee in section 6 of CMS-855A
  • Adverse legal history box must be checked in section 6 of CMS-855A for each individual listed
  • Providers should read all directions related to sections 5 & 6 of CMS-855A as many providers have very extensive managing control and organizational structures. All appropriate entities, individuals, and documents must be provided
  • Federally Qualified Health Centers (FQHCs) are allowed only one location in section 4a of CMS-855A. This location must be indicated on HRSA agreement, which is a required attachment to CMS-855A for FQHCs
Last Updated Aug 20 , 2018