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The document is the Medicare Supplier Enrollment Application (CMS-855B) for clinics, group practices, and certain suppliers. It outlines the process for enrolling in the Medicare program, including eligibility criteria, required documentation, and instructions for completing the application. Specific sections detail information on billing numbers, ownership interests, practice locations, and necessary attachments for various supplier types. The document emphasizes compliance with Medicare regulations and includes a privacy act statement regarding the handling of personal information.

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What is CMS-855B?

What is the 855B? \u2756 The CMS form used for the enrollment of Clinic/Group practices and Certain Other Suppliers. This form is also used to submit changes to your enrollment data.

What is a CMS 855A form?

What is the 855A? \u2756 The Medicare Enrollment Application for Institutional Providers. \u2756 This form is also used to submit changes to your enrollment data.

What is an 855A?

What is the 855A? \u2756 The Medicare Enrollment Application for Institutional Providers. \u2756 This form is also used to submit changes to your enrollment data.

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What is Medicare Form 855B?

CMS 855B. Form Title. Medicare Enrollment Application - Clinics/Group Practices and Certain Other Suppliers. Revision Date.

What is one reason why a provider would complete a CMS 855B form?

You need to complete a new CMS-855 when: An individual or entity is requesting initial enrollment into the Medicare program. Changes are being submitted to update enrollment information and the individual or entity does not have a completed enrollment application (CMS-855) on file.

How long does 855B take to process?

Most applications will be completed, reviewed and placed in the mail within 2 business days.

What is 855I?

\u2756 855I. \u2022 CMS form which enrolls physicians and non-physician practitioners who. render Medicare Part B services to beneficiaries. \u2022 Enrolls practitioners who are the sole owner of a professional corporation. and bill Medicare through this business entity.

What is a Medicare 855B form?

CMS 855B. Form Title. Medicare Enrollment Application - Clinics/Group Practices and Certain Other Suppliers. Revision Date.

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