Medicare provider Enrollment time frame - How to make it quicker

How you can expedite your enrollment application process

As the Medicare administrative contractor (MAC) for jurisdiction N (JN), First Coast Service Options Inc. (First Coast) is not only responsible for processing Medicare claims but also for processing enrollment applications for providers and suppliers located in Florida, Puerto Rico, and the U.S. Virgin Islands.

The Centers for Medicare & Medicaid Services (CMS) has established the following timeliness standards for contractors responsible for processing enrollment applications within their assigned jurisdictions:

• PECOS Web applications (initial enrollment with no site visit) -- 80% must be processed within 45 days

• Paper-based applications (initial enrollment with no site visit) -- 80% must be processed within 60 days

• Paper-based applications (initial enrollment with site visit) -- 80% must be processed within 80 days

• Paper-based applications (changes to enrollment record or reassignment) -- 80% must be processed within 60 days

First Coast Provider Enrollment Average YTD Processing Times

(Through August 31)

 

PECOS Web Applications

Part A                Part B

 

No development 23 days 31 days

With development 83 days 60 days

Paper Applications

 

No development 36 days 26 days

With development 91 days 57 days

Factors affecting total processing times

Although First Coast processes each enrollment application as quickly as possible, the following key factors may affect the total processing time needed:

• Provider type:

• Part A -- institutional providers

• Part B -- physicians, non-physician practitioners, clinics, and group practices

Shortest processing times: Enrollment applications for Part B providers and suppliers

• Application type:

• PECOS Web application -- an electronic enrollment application submitted through the Internet-based Provider Enrollment, Chain, and Ownership System (PECOS) website external link.

• Paper-based application -- a paper enrollment application that is printed and submitted through the mail.

Shortest processing times: PECOS Web applications

• Development required:

• No development -- the enrollment application (paper-based or electronic) is accurate, complete, and is submitted with all required support documentation.

• With development -- the enrollment application (paper-based or electronic) falls into one or more of the following categories:

• Contains errors or inconsistencies

• Incomplete (e.g., missing information or signature)

• Support documentation missing or insufficient

Shortest processing times: Enrollment applications that do not require development

Tips for expediting your enrollment application process

• Use Internet-based PECOS external link

• 25% faster processing time than paper-based enrollment

• Automatic selection of appropriate enrollment form

• Tailored application process

• Fewer errors

• Avoid development requests:

• Review and follow: Documentation requirements for physician and non-physician practitioners.

• Check your application for completeness and accuracy before submission (e.g., required sections completed, inconsistent/incorrect information corrected).

• Submit signed and dated Certification Statement -- all signatures must be original and signed in ink (blue ink preferred). Note: Stamped, faxed, or copied signatures will not be accepted.

• Track your enrollment status online: Use First Coast’s Enrollment status lookup

• Search for all pending applications -- enter your NPI and PTAN

• Search for application status -- enter correspondence control number (CCN) and three-digit tracking number