Section 6401(a) of the Affordable Care Act established a requirement for all enrolled providers and suppliers to revalidate their Medicare enrollment information under new enrollment screening criteria. This revalidation effort applies to those providers and suppliers that were enrolled in Medicare prior to March 25, 2011. We previously completed Phase I and Phase II of this project. We have entered Phase III, which includes sending letters to the remaining 70% of providers in Jurisdiction H and Jurisdiction L that have not received a revalidation request from Novitas. These letters will be sent to two of the following addresses; correspondence, special payment (aka pay-to) or primary practice address.
There is no need to take any proactive measures at this time. However, if/when you receive a request for revalidation; please follow the instructions in the letter very carefully. Remember that failure to submit the appropriate required enrollment forms may result in the deactivation of Medicare billing privileges.
When completing the revalidation form, please be sure that all fields are filled out completely and accurately. Novitas is developing on approximately 80% of revalidation paper applications and approximately 40% of revalidation web applications that we receive. The top reasons for development are listed in the chart below.
Section 1A - 855I
Section 2A - 855I
Section 3 - 855I / 855B / 855A
Section 4A - 855I
Section 4B - 855I
Section 4A / 4C - 855I / 855B
Section 5 and / or 6A / B - 855B / 855A
Section 8 - 855B / 855I
Novitas will develop to obtain any missing or incomplete information. If the information is not received within the timeframe outlined in the development letter, you run the risk of having your provider number deactivated.
Please make sure to submit your paperwork correctly on the first submission and if requested, respond to the development letter within the timeframes indicated.
If you have specific questions on how to revalidate, please review our Revalidation FAQs (Frequently Asked Questions).