Top Reasons for Delays - JF Part A
Top Reasons for Enrollment Delays
- Section 2B 1of the 855A must reflect the Legal Business Name as it appears on the IRS document.
- Section 4A of the 855A should reflect the last four digits of the zip code for the provider.
- If a hospital has more than one practice location listed in section 4A of the 855A, the provider should indicate the type for the other locations listed.
- At least one individual must be marked as a managing employee in section 6 of the 855A.
- The adverse legal history box must be checked in section 6 of the 855A for each individual listed.
- We strongly recommend the provider read all directions related to sections 5 & 6 of the 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 the 855A. This location must be indicated on the HRSA agreement, which is a required attachment to the 855A for FQHCs.
Last Updated Mon, 20 Aug 2018 08:43:36 +0000