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Dnrwigov Form 9400 379

Dnrwigov Form 9400 379

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Instructions and help about Dnrwigov Form 9400 379

welcome to enrollment on demand in this video we will learn how to complete a reassignment by following these step-by-step instructions delays and application processing can be avoided the information given in this training is correct as of the date of publication the most current information contained in this presentation can be found on the nerian Medicare website and the CMS website at the links listed on this slide submitting an application for a reassignment begins with selecting the correct form go to the Naran website forms and under provider enrollment select the CMS 855i the link takes you directly to the CMS posted form let's take a walk through the sections to complete enter information starting with Section 1A on page four for a provider who is already enrolled with Medicare complete the following sections 1 2 a 3 4f 12 13 and 15 in section 1A reporting A Change Is selected due to already being enrolled on page four in section 1B Mark what is changing in this instan

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