successfull submission of enrollment application - provider
How will I know if I have successfully submitted my
enrollment application?
Once the Internet application has been electronically
submitted, the "Submission Receipt" page appears. This page informs
the physician or non-physician practitioner that the Internet application has
been submitted for processing. The "Submission Receipt" page reminds
the physician or non-physician practitioner that the Certification Statement
must be signed and the Certification Statement and the supporting documentation
must be mailed to the contractor. PECOS sends a notification reminder to each
e-mail address listed in the contact person information section of the
application.
Note: A Medicare contractor will not process an Internet
enrollment application without the signed and dated Certification Statement and
the required supporting documentation. In addition, the effective date of
filing an enrollment application is the date the Medicare contractor receives
the signed Certification Statement that is associated with the Internet
submission.
The Certification Statement must be signed by the physician
or non-physician practitioner enrolling or making a change to his/her
enrollment information. Signatures must be original and in ink (blue ink
recommended). Copied or stamped signatures will not be accepted.
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