PTAN Reminders and Tips
March 2018 Issue
As a Medicare provider, you have completed CMS' 27-page 855S Medicare Enrollment Application, had a successful site visit, and received a provider transaction account number (PTAN) that identifies your practice as a Medicare supplier in good standing. With a PTAN you can bill Medicare for the services you provide to patients. It is all too often that my office receives a call from a provider with an urgent PTAN question or concern. Here are some tips to help your practice avoid common PTAN dilemmas.
Did you know your PTAN will be deactivated if you have not billed Medicare for four consecutive quarters? If your practice has multiple offices and multiple PTANs, you must ensure that Medicare regularly receives claims that use each location's PTAN. To prevent deactivation, avoid using only one location as the billing location, as only that office's PTAN will be on the claim. Should you not use a PTAN for four consecutive quarters, you will receive a deactivation letter from the Medicare Administrative Contractor (MAC), and deactivation will occur ten days from the date of the letter. If Medicare deactivates your PTAN, you will be required to reenroll by completing a new 855S form.
Every three years, suppliers are required to revalidate their PTAN number.The revalidation process allows Medicare to ensure all information is current and the supplier is still in compliance with the Medicare supplier standards. The MAC will send you a notice of revalidation two to three months prior to your revalidation due date. You should keep track of the revalidation dates for all your locations internally rather than relying on receipt of the letter. It is not uncommon for clients to tell me they were unaware of the deadline, didn't see the letter, and missed the revalidation. CMS has established a tool at https://data.cms.gov/revalidation that lists revalidation due dates for the coming six months.
If one of your facilities changes its payment address, you must notify the National Supplier Clearinghouse (NSC) immediately, and CMS must be made aware of any change to your 855S form within 30 days of the change. As part of CMS' Do Not Forward Initiative, in place since 2002, any correspondence that is sent to an undeliverable address will be returned to your MAC. The MAC places a "do not forward" code in the system and suspends any payments. The MAC will also notify the NSC that the information on the 855S is incorrect. The NSC will notify the other regional MACs, and all payments will be suspended. If the supplier cannot be reached within 45 days, the supplier number will be deactivated.
Don't rely on the post office to forward your mail if your office changes addresses. Make the necessary changes to your CMS 855S immediately.
Keeping these tips in mind should help your practice avoid some of the common PTAN issues and ensure you keep your Medicare supplier status in good standing.
Erin Cammarata is president and owner of CBS Medical Billing and Consulting. She can be contacted at email@example.com.