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Top Revalidation Development Reasons

DEVELOPED FOR RESOLUTION
CP575 or other IRS document Attach a copy of your Internal Revenue Service (IRS) CP-575 validating your tax identification number (TIN) with your legal business name. The CP575 is the letter you receive from the IRS granting your Employer Identification Number (EIN) which reflects your legal business name and EIN. Acceptable tax documents must be generated and pre-printed by the IRS. An example of another acceptable document is the IRS substitute letter 147C. A W-9 is not acceptable.
CMS 855I Section 1A ALL of the applicant's active PTANs and the NPI are identified in Section 1A. If the revalidating applicant is a provider sole owner, ALL of the sole owner's active individual PTANs and the sole owner's individual NPI are required in Section 1A.
CMS 855B and CMS 855I Section 2 Correspondence Telephone Number The correspondence telephone number listed in Section 2 is called to verify that the contractor can directly contact the applicant. The contractor only needs to verify that the applicant can be reached at this telephone number.
CMS 855I Section 4B Section 4B requires the name, Medicare identification number(s) and NPI for each group the applicant has an active reassignment affiliation.
Voided check / Bank Letter Groups/organizations and sole proprietors that submit the CMS 588 (EFT) must include confirmation of account information on bank letterhead or a voided check. Documentation must contain the name on the account, electronic routing transit number, account number and type. If submitting a bank letterhead, the bank officer's name and signature is also reequired.
CMS 855B and CMS 855I Section 4 Practice Location Groups/organizations and sole proprietors complete Section 4 (Practice Location) for each practice location where services are rendered to Medicare beneficiaries.

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