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Cl855 Form Education

Cl855 Form Education

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Instructions and help about Cl855 Form Education

Hi everyone. Welcome and thanks for joining  me today. My name is Thom Ryan with Provider  Outreach and Education at WPS Government Health Administrators. I'll be your presenter for this video. Today I'd like to cover facilities enrolling with the CMS form 855A. This video provides instructions for completing section two items C and D. These two items are correspondence addresses. Item C contains your main correspondence address. This is a mailing address for any Medicare communications not related to medical records. Item D is used for medical records correspondence address. This address is used for mailing any medical record communications. The two addresses can match but they must be to the provider, not a billing agency or medical management company. Let's cover item C for correspondence address on page 11 first. If you're changing the address in your Medicare enrollment record, then check the change box and enter the effective date ofÂ

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