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How to use or fill out 855i with our platform
- Click ‘Get Form’ to open the CMS-855I in the editor.
- Begin with Section 1A, where you must enter all individual Medicare identification numbers (PTANs) alongside your NPI. Ensure to check the revalidation box.
- Proceed to Section 2, completing all subsections (2A, 2B, and 2C) as they apply to your application process.
- In Section 3.1, if you answer 'Yes', make sure to complete Section 3.2; simply stating 'See Attached' is not acceptable.
- Fill out Section 4B with all association information for each PTAN identified in Section 1A.
- Finally, ensure that you provide an email address and fax number in Section 13 and sign in Section 15 before submitting your form.
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