Avoid Lost Revenue! Medicare Revalidation Matters
Missing your Medicare revalidation can result in lost payments and unenrollment, leaving you unable to collect from Medicare or your patients. Check your revalidation status every six months on CMS and complete all required documentation to stay compliant.
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Transcript:
Last year, we did a video that walked through how to check your Medicare revalidation, and we didn’t realize how actually important it is, but it is critical. We’ve had a number of our doctors who have called in, and we have found out that there has been a gap in their validation status with Medicare. So what happened was they got notified that they were required to do a revalidation with Medicare. They missed the communication, they missed the window, and ended up with a gap before they caught the problem. This resulted in actually, quite a bit of missed payments. When you miss your revalidation, you are unenrolled from Medicare, which means you can’t be compensated for any of the services. Ultimately, you can’t collect from the patient, and you can’t collect from Medicare, because remember, as chiropractic physicians, you cannot opt out of Medicare. So ultimately, it left these funds unrecoverable at all. This is an incredibly important step, and we don’t want our doctors to miss it, so please don’t miss this verification.
I’m just going to grab actually our screen share from last year does a great job of walking through exactly how to verify your current status with Medicare. It’ll walk you through how to check it. This is important you want to check it for all of the providers in your practice, all of them as well as you want to make sure that you’re also checking for your group NPI or your practice NPI. So you’re going to check each NPI for all of your providers, and you’re also going to check your group NPI. So most likely, the minimum you’re going to check is two unless you’re a sole proprietor and you’re filing everything under a single NPI, and you’re the only one in your practice, so make sure you’re checking all of your NPIs, and additionally, do this walk through now we do also help you track this in Statusfi. That’s your dashboard for compliance that that’s available to ICS members for free. It’s a part of your membership with the ICS. And we actually moved up because we’re seeing this problem more frequently. We moved up that time frame to ensure that our doctors are checking it every six months instead of every year. So you want to make sure that you’re checking this at least every six months go through the revalidation process. It is absolutely worth it. Check this out.
What you want to do is you want to go to data.cms.gov/revalidation, that’s data.cms.gov/revalidation. It’s going to take you to this Medicare revalidation list. And it’s really this simple, I want you to ignore most of the blanks on here and just really hone in on the search by NPI. And in this particular case, you’re going to enter in your NPI here, and then you’re going to click on find a provider. And once you do that, you’re going to see one of two things come up. The first is, if you have a revalidation that is due, you’re going to see if it’s an organization, this is exactly what it would look like. You’ll have the due date here of when the revalidation has to take place. Incidentally, if you have a due date, now’s the time to go ahead and complete your revalidation.
You do that through the Pecos system. So go into Pecos and handle your revalidation there. And I’m going to talk about one of the components that come up in a question recently just to make sure that you’re covered on that and you don’t skip it. But due date here means to go to Pecos and complete your revalidation.Now if you are not ready for revalidation, you will see this come up and you’ll see this come up is due date TBD, or to be determined in this particular case, there’s nothing for you to worry about nothing for you to do. So you want to go ahead and at that stage, don’t worry about it. Right? This is something to come back and check again. And check this every few months. But the biggest thing is this, you want to make sure that you watch closely, all of your Medicare communications. Because what we have seen is if you don’t go through the revalidation process, we’re seeing providers no longer be reimbursed by Medicare. So you want to make sure that that revalidation is complete. Now when you’re going through that revalidation, make sure you complete everything. Now, in theory, you shouldn’t be able to advance through and complete the entire revalidation if you haven’t done parts of it. But we have heard from at least one doctor who has had a challenge with the organizational chart. And so when they asked for the organizational chart, if you don’t upload that chart, they’ll basically send you a deficit issuance meaning that you have to provide additional information before they can complete your revalidation. And in those cases, many times you have to send it outside of the Pecos system, meaning mail it or fax it or some other types of communication.
So you want to make sure when you complete it, make sure you do everything including the organization chart. In that organizational chart. You’re not talking about all of your employees, you’re talking about those key role players in your organization. Typically it’s going to be used by the owner and any other people who you have listed as a member of your board of directors when you’re doing your group NPI, if you will, or if you’re doing your business revalidation in those cases. You know, we’re talking about if obviously, if you’re sole proprietor it would be you. If you’re a corporation, it’s going to be you and any listed officers/ directors and managing employees. Now, managing employees, this is somebody who has significant control over your practice. Somebody who’s making decisions for your overall practice day in and day out. That’s when they talk about managing plants. If somebody, basically at the CEO level of your company or your practice, if you have somebody in that role that is not you. And then these cases you just want to list all of your owners that have greater than 5% ownership in your practice. And so if there are multiple different physicians that have ownership in your Medical Corporation in those cases, you would list all of them in that organizational chart and make sure that you do upload that as a part of your revalidation. Hopefully, this information helps you out and we will catch you next week.
