New screening requirements under the Accountable Care Act require all healthcare providers to revalidate. Medicare and Medicaid both must be revalidated approximately every five years.
Your Medicare Administrative Contractor will send a revalidation notice within 2-3 months prior to your revalidation date. They will mail to at least two of your reported addresses, billing address, correspondence address or primary practice address.
The most efficient way to submit your revalidation information is via the internet using PECOS. This enables you to:
Review information currently on file
Update and submit your revalidation
Electronically sign after uploading supporting documents
Submit a complete revalidation application by your due date, and respond on time to all related requests from your MAC to avoid:
Possible hold on your Medicare payment
Deactivation of your Medicare billing privileges
Deactivated providers will be required to submit a complete application to reactivate their enrollment but:
Will maintain their original PTAN
Reactivation date will be date of receipt of new complete application
No payments will be made for the period of deactivation
KMAP: The Kansas Medical Assistance Program will mail letters to the providers 60 days before the revalidations are due.
If you are inactivated with KMAP, you have the opportunity to back date your revalidation to maintain continuity of enrollment if you complete the revalidation within 30 days from the revalidation due date. Once approved, you will be eligible to submit claims for the time period when you were inactive. While your enrollment status is inactive, you will not be able to bill KMAP. After 30 days from the due date you must start a new application and will have a new effective date leaving you a lapse in coverage. Inactivation of KMAP enrollment will affect all KanCare payments. Log onto the KMAP website with your credentials and click provider revalidation application and follow the prompts.
Medicare is taking steps to remove Social Security numbers from Medicare cards. CMS will issue new Medicare cards with a unique, randomly assigned number called Medicare Beneficiary Identifier to replace the existing social security number. There will be a 21-month transition period where providers will be able to use either the MBI or the HICN for billing purposes to further ease the transition.
Therefore, even though your systems will need to be able to able the new MBI format by April 2018, you can continue to bill and file health care claims using the Medicare beneficiary's HICN during the transition period.
For more information go to CMS's provider website and sign up for the weekly MLN Connects newsletter.
Preferred Health Systems is now officially Coventry Health Care of Kansas, Inc.
Our participation agreement is now with Coventry. All references to Preferred Health Systems in our agreement have been changed to Coventry Health Care of Kansas, Inc.
In time, they will simply be known as Aetna. Member's benefits are not changing because of the name change. New and replacement ID cards will have the Coventry logo. Preferred Health Systems has been removed from directprovider.com. Please call 1-866-427-9719 with any questions.
Physician Hospital Organization