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GOVERNMENT ENROLLMENTS

MediQuin prepares applications such as Medicare, Medi-Cal, Cal-Optima, California Children’s Services Program, and Medical Services for Indigents, Emergency Medical Services Fund, National Provider Identifier and Unique Physician Identification Numbers.

 

 
The Medicare Enrollment Application

The Medicare enrollment application is used to collect information about the provider and to secure the necessary documentation to ensure you are qualified and eligible to enroll in the Medicare program. Suppliers, other than suppliers of Durable Medical Equipment, use three different enrollment application forms to enroll or change their Medicare enrollment information. They are CMS-855B, CMS-855I andCMS-855R. Some additional forms may accompany the enrollment process like CMS-588 or CMS-460.


The Medi-Cal Enrollment Application

Providers must be licensed and accredited according to the specific laws and regulations that apply to their service/provider type. To receive a Medi-Cal provider number, the appropriate application package must be submitted with required attachments. While group provider numbers are assigned to each physical location that delivers services to Medi-Cal recipients. Reporting changes to provider enrollment is a provider's responsibility within 35 days of any change in previously submitted information.


National Provider Identifier (NPI)

The National provider Identifier (NPI) will replace health care provider identifiers in use today in standard health care transactions. Suppliers must obtain their NPI prior to enrolling in the Medicare program. Enrolling in Medicare authorizes you to bill and be paid for services furnished to Medicare beneficiaries. National Provider Identifiers will be required on claims sent on or after May 23, 2007.


Unique Physician Identification Numbers (UPIN)

Medicare Unique Physician Identification Numbers will be assigned only to physicians and the following non-physician practitioners: Nurse Practitioners (NPs), Clinical Nurse Specialists (CNSs), and Physician assistants (Pas), and Certified Nurse Midwives (CNM). Recent analysis of the Top 10 reasons for unprocessable claims indicates the Name and UPIN of the referring/ordering provider has not been entered or accurately entered on the CMS-1500 claim form, or the electronic equivalent.


 

 

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