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How to use or fill out cms 855i with DocHub
- Click ‘Get Form’ to open the CMS 855i application in our platform's editor.
- Begin with Section 1, Basic Information. Fill in your Medicare Identification Number and National Provider Identifier (NPI) as required.
- Proceed to Section 2, Identifying Information. Enter personal details such as your name, date of birth, and social security number. Ensure all information matches your official records.
- In Section 3, provide any final adverse legal actions or convictions if applicable. This section is crucial for compliance.
- Move to Section 4 for Practice Location Information. List all practice locations where you will render services to Medicare beneficiaries.
- Complete the Certification Statement at the end of the form by signing and dating it. Remember that only original signatures are accepted.
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