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 Jun 26 , 2025