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 Enrollment Form Active DONE Lausdemployment Org 2018

2018-2025 Form

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Instructions and help about Enrollment Form Active DONE Lausdemployment org

Hi and welcome. Thanks for taking the  time to watch this video. My name is Thom Ryan with provider Outreach and Education at WPS Government Health Administrators. I'm here to help you understand this video and its content. This is an instructional video to help you complete section four of the CMS form 855I for physician and non-physician practitioners who need to make a change to their Medicare enrollment or enroll in Medicare for the first time. Section four is the business information for the individual taking an enrollment action with Medicare. Not all enrollment actions require an individual to complete section four. So, let's begin by determining if section four needs to be completed. To determine if you need to complete section four, begin by moving to section 1A on page 4. This section allows you to choose what options you're going to do with your enrollment record. This is why it will determine whether or not you need to complete compl

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