Obtaining a Medicare Billing Number
To bill Medicare, physicians and other suppliers must first obtain a Medicare billing number referred to as a Provider Identification Number (PIN). To obtain a PIN physicians and other suppliers must complete the appropriate CMS 855 form (provider/supplier enrollment application) and submit it to the Medicare contractor. The PIN is used to bill Medicare for services or items furnished. Physician/suppliers should protect their PIN like a credit card number and ensure that others do not use it to bill Medicare without their knowledge. Any misuse of the PIN should be reported immediately. Please refer to Chapter 2, Medicare Part B Physician Enrollment, for more information.
Closing, Relocating, Change In Status, or Changes
In Members Physicians and other suppliers are required to contact Medicare to update records. Additional information regarding application for billing numbers, adding/deleting group members, or changes to ad- dresses is available through the CMS Web site at www.cms.gov/providers/enrollment on the Internet.
Medicare Part A Providers
Providers wishing to obtain application information or to make changes to an existing application or file must contact the fiscal intermediary responsible for their enrollment.
Medicare Part B Physicians/Suppliers
Physicians or other suppliers must inform their Medicare contractor if they decide to close or move their practice or change members of a group. PINs must be updated in Medicare ’ s database so that another physician or entity cannot use it. Please refer to Chapter 2, Medicare Part B Physician Enrollment, for more information.
Reassignment of Benefits
Generally speaking, Medicare pays the physician who performed the service. In limited situations, however, Medicare may allow the performing physician to reassign Medicare payments to another physician or entity. This is called reassignment of benefits and requires that various forms be completed, signed, and returned to the Medicare contractor.
A fully executed Reassignment of Benefits form (CMS 855R) is powerful because it allows another person or entity to bill Medicare on the physician ’ s behalf and receive payment that otherwise would have been sent directly to the physician. If a physician has authorized someone else to bill and be paid by Medicare for services that he or she renders, the physician retains responsibility for ensuring that such billings are appropriate and reflect services actually performed.
