Introducing our New Enrollment Center

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Introducing our New Enrollment Center
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www.highmarkmedicareservices.com/enroll
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Features on Enrollment Center

• Overview of the enrollment process and processing
  timeframes,
• Links to CMS' system to submit internet-based
  enrollment applications,
• Links to all other CMS paper enrollment
  applications/forms,
• A comprehensive A/B Enrollment Reference Guide,
• Frequently Asked Questions, and
• Tips/tutorials to aide in completing enrollment
  forms.
• Check these features and others on the new
  Enrollment Center www.highmarkmedicareservices.c
  om/enroll

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Coming Soon!

• A decision logic table to assist new and existing
  enrollees in selecting the appropriate enrollment
  form(s) to complete
• A tool to check the status of your applications
  on-line
• We expect to implement these later this spring.

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Provider Enrollment at HMS

• Providers can enroll or submit changes to
• an existing enrollment record via either
• Paper Applications (CMS-855s)
• Internet-based Enrollment Process (PECOS Web)

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Helpful Hints for Paper CMS-855 Forms

• Tips for Completing / Submitting Paper
  Applications
• Complete the appropriate application for your
  provider type
• Complete all required sections (including
  checking N/A where appropriate)
• Report your NPI and CCN/PTAN (if issued) on the
  application
• Report the name (e.g., legal business name) as is
  reported to the IRS
• Include all required supporting documentation
• Sign and date the application (preferably in blue
  ink) stamped or copied signatures are not
  accepted

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Internet-Based PECOS Web Enrollment Is
Available

• Conducting transactions via Internet-based PECOS
  is
• Efficient
• Submission of the Internet-based enrollment
  application is faster than completing and
  submitting a paper enrollment application
  (CMS-855).
• You can enroll, make changes/corrections to
  existing enrollment records, and check the status
  of PECOS web enrollment applications.
• Secure
• Only authorized individuals with User IDs and
  Passwords can access and submit a PECOS web
  enrollment application.
• Easy
• The scenario-driven application process helps to
  ensure completion and submission of only the
  information necessary to enroll or make a change
  in an existing enrollment record.
• PECOS web offers front-end editing capabilities
  and a built-in help screen
• Currently available for physicians, non-physician
  practitioners, provider and most supplier
  organizations. It is currently not available for
  suppliers of durable medical equipment,
  prosthetics, orthotics, and supplies (DMEPOS)
• Access the PECOS web enrollment application
  http//www.cms.hhs.gov/MedicareProviderSupEnroll/

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Steps to Use PECOS Web

• There are three basic steps to completing an
  Internet-based PECOS Web Enrollment Application
• Must have an NPPES User ID and password.
• Go to https//pecos.cms.hhs.gov and complete,
  review, and submit the electronic enrollment
  application.
• Print, sign, and date the two-page Certification
  Statement and mail the Certification and all
  required supporting paper documentation to
  Highmark Medicare Services within seven days of
  electronic submission.
• Note Failure to submit the original, signed
  Certification and all required supporting
  documentation will result in the application
  being rejected.

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Helpful Hints to PECOS Web

• Tips for Completing / Submitting via PECOS Web
• If your enrollment occurred prior to 2003 and no
  updates/changes have been submitted since 2003,
  then a complete initial enrollment application
  must be submitted, either via PECOS web or the
  paper CMS-855 process.
• An original signed, dated Certification Statement
  and ALL supporting documentation must be
  submitted to HMS within 7 days of the submission
  of the electronic application.

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CMS-defined Processing Standards

• Initial Enrollment/Reactivations
• Paper Applications Contractors are required to
  process 80 of initial applications within 60
  calendar days of receipt.
• Internet-based (Web) PECOS Applications
  Contractors are required to process 90 of
  applications within 45 calendar days of receipt.

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CMS-defined Processing Standards (cont.)

• Changes
• Paper Applications Contractors are required to
  process 80 of change request applications within
  45 calendar days of receipt.
• Internet-based (Web) PECOS Applications
  Contractors are required to process 90 of change
  request applications with 45 calendar days of
  receipt.

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Enrollment Mailing Addresses

• Paper enrollment forms and supporting
  documentation, certification statements/supporting
  documentation for Internet-based PECOS submitted
  applications, and other enrollment forms (e.g.,
  CMS-460, CMS-588) must be sent through the U.S.
  mail to the address below.
• Provider Enrollment ServicesHighmark Medicare
  ServicesPO Box 89XXXXCamp Hill, PA 17089-XXXX
• Substitute the XXXX with the appropriate PO Box
  number and 4-digit zip from the table below
• State PO Box Number/4 Digit Zip
• Pennsylvania Part A 0385
• Maryland/ District of Columbia Part A 0386
• New Jersey Part A 0420
• Delaware Part A 0417
• Pennsylvania Part B 0157
• Maryland Part B 0406
• New Jersey Part B 0036
• District of Columbia Metro Area Part B 0407
• Delaware Part B 0408

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Enrollment Help Line

• Effective April 27, 2009, the Enrollment Help
  Line hours of operation at 1-866-488-0549 are
  expanding and will now be available between the
  hours of 800 a.m. and 330 p.m. Monday through
  Friday.
• Please have your CCN, PTAN, and/or NPI number
  available to assist in expediting the
  call. NOTE The Enrollment Help Line should not
  be used for checking the status of an
  application. For status, you should directly
  contact the Credentialing Specialist, as was
  referenced on your acknowledgement or development
  letter.