Q:

How do you complete a Medicare CMS-855I enrollment application?

A:

Quick Answer

Physicians and nonphysician providers may mail the CMS-855I form to the local Medicare fee-for-service contractor, or they can use the Internet-based Provider Enrollment, Chain and Ownership System, states the Centers for Medicare and Medicaid Services. They must include all supporting documentation with their applications.

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Full Answer

The CMS-855I form is available as a downloadable Adobe Acrobat file that applicants can fill out on their computers before printing, explains the Centers for Medicare and Medicaid Services. They must sign the document in their own handwriting before mailing it to the Medicare contractor, also called a carrier, fiscal intermediary, Medicare Administrative Contractor or National Supplier Clearinghouse. Mailing the application directly to the Centers for Medicare and Medicaid Services may lead to a delay in processing it.

The PECOS system helps applicants to fill out the correct information for each part of the application, according to the Centers for Medicare and Medicaid Services. PECOS requires Internet Explorer 5.5 or higher and the most recent version of Adobe Acrobat. Providers use the same user identification and password they received from applying online to the National Plan and Provider Enumeration System for their National Provider Identifier. At the end of the online application, providers should receive a Certification Statement that they must sign and mail to the Medicare contractor with the supporting documentation.

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