Medicare Part A and B Enrollments Revalidation Phase III Target List

$179 / year

This dataset consists of Medicare Phase III target list which revalidates all remaining providers including providers reassigning their benefits to some of the large organizations they are affiliated with. Large organizations are considered as groups with 200 or more reassignments.

Complexity

CMS will provide the Medicare Administrative Contractors (MACs) 9 lists every 60 days of those providers required to revalidate. MACs will have 60 days from receipt of the list to mail the letters. MACs may stagger the mailings however they see fit as long as they are completed within that 60 day timeframe.

Within 15 days of receiving the CMS list, MACs will mail a notification letter to the large organizations giving them a heads up that members of their group will be receiving a request to revalidate in the next 60 days.

The letter will be mailed to the group’s correspondence address and will contain a spreadsheet identifying the provider’s Name, NPI and specialty (see attached sample letter and spreadsheet).

The group notification letter is just a heads up. Providers/group should not take any action to revalidate based on the notification letter sent. Providers/group should wait until they receive the official revalidation letter from the MAC in a colored envelope before taking any action. CMS will look into whether a specific color can be used by all MACs.

CMS we will work with each MAC to ensure they are sending the group notification letter to the enrollment contact.

CMS encourages providers/groups to revalidate online. Doing so gives the providers/groups a head start. They are able to prepare the app but should wait to submit and e-sign until the revalidation letter is received.

Revalidation letters are sent to the provider’s special payment and correspondence address. If the provider reassigns to multiple groups and another group’s address is listed as their special payment address/correspondence address, that group will receive the letter. If your group is responsible for maintaining the provider’s enrollment then you should work with your providers to update their correspondence address to match yours or have them on the lookout for the revalidation letter.

Extensions are still available if more time is needed to complete the revalidation process. Extension requests should be coordinated with your MAC. If needed, CMS will coordinate group extensions rather than requiring each provider to request an extension individually.

Date Created

2014-03-07

Last Modified

2017-03-30

Version

2017-03-30

Update Frequency

Semimonthly

Temporal Coverage

N/A

Spatial Coverage

United States

Source

John Snow Labs; Centers for Medicare and Medicaid Services;

Source License URL

Source License Requirements

N/A

Source Citation

N/A

Keywords

Medicare Part A Enrollments, Medicare Part B Enrollments, Medicare Phase III Target List, CMS Data, Medicare Revalidations, Medicare Enrollment

Other Titles

Medicare Revalidation Phase III Target List for Providers and Suppliers, Medicare Part A and B Enrollments Revalidation Target List

NameDescriptionTypeConstraints
National_Provider_IdentifierUniversal identifier of healthcare providers. Also called NPIstring-
Name_of_ProviderLegal business name of the provider (organizations only) and first and last name of the provider (individual)string-
Enrollment_State_CodeCode for the US state of the Medicare contractor that assisted in the enrollmentstring-
National Provider IdentifierName of ProviderEnrollment State Code
1427019413HILLCREST HEALTHCARE COMMUNITIES INC ISLAND HOME PARK HEALTH AND REHABTN
1487767026MIDMICHIGAN STRATFORD VILLAGE N/AMI
1659461143FAMILY HEALTH CARE ASSOCIATES OF BARBOURVILLE INC FAMILY HEALTH CARE ASSOICATES OF BARBOURVILLEKY
1336119627BAPTIST WOMEN'S HEALTH CENTER LLC THE HOSPITAL FOR SPINAL SURGERYTN
1215907951WEST CENTRAL KANSAS ASSOCIATION, INC. RUSSELL REGIONAL HOSPITAL PHYSICIANS CLINICKS
1164475711WARSAW HEALTH SYSTEM LLC KOSCIUSKO COMMUNITY HOSPITALIN
1295700201DVA RENAL HEALTHCARE INC SAN YSIDRO DIALYSISCA
1508828765DVA RENAL HEALTHCARE INC MOUNTAIN VIEW DIALYSISNV
1235193905DVA RENAL HEALTHCARE INC RELIANT DIALYSISTX
1427024819DVA HEALTHCARE RENAL CARE INC BRENTWOOD DIALYSISDC