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welcome to enrollment on demand in this video we will learn how to fill out the cms-855a to enroll as a rural health clinic by following these step-by-step instructions it will help to avoid delays in the application processing the information given in this training is correct as of today the most current information contained in this presentation can be found on the nuridium medicare website and the cms website at the links listed on this slide when completing an initial application for a rural health clinic include an irs document and the cms 588 eft with a voided check or bank letter if the organization will be provider-based include a provider-based attestation statement there are other situational supporting documents that are required what documents are required are included with the appropriate sections of the application be sure when completing addresses to use the usps formatting to stay within the pecos field character limits a fee is required for the new rule health clinics