CMS News: Stay of Enrollment

The following content was provided by Acevedo Consulting

Effective May 30, a provider or supplier may be subjected to a stay of enrollment if they are deficient in one provider enrollment requirement which can be remedied by submitting a provider enrollment application. A stay of enrollment is a preliminary, interim status representing a pause in enrollment during which you will not be paid.

During a stay of enrollment, or pause, your provider status remains active in Medicare, but Medicare will reject all claims submitted with a date of service within the stay period.
 
Some examples of when a stay of enrollment may be implemented:

• Provider failed to timely report a change in address
• Supplier didn't respond to a revalidation request
• Independent diagnostic testing facility failed to comply with a supplier standard
• A supplier failed to timely report a change in address of an organizational owner
• A supplier failed to report the deletion of a managing employee

Note: If a stay of enrollment has been placed on your enrollment record, you will be notified by hard-copy mail, email, and fax, if applicable. To have the stay of enrollment removed, you must fix the non-compliance with Medicare by submitting the applicable Medicare application. Remember, if you need help, Acevedo Consulting has the expertise to assist with Medicare enrollment.
 
For example: Your clinic group practice recently changed practice locations and did not notify Medicare. Your MAC implemented a stay of enrollment because you did not report a change in practice location. To have the stay of enrollment removed and be able to continue billing Medicare, you will have to submit a change of information enrollment application to update your practice address.

If you believe you meet all provider enrollment requirements and the stay of enrollment should not have been imposed, you can submit a provider enrollment rebuttal. Refer to your stay of enrollment letter for instructions on how and where to submit the rebuttal.
 
 
For more information, click here. 

Source: Acevedo Consulting 

https://www.acevedoconsultinginc.com/