CMS has established Internet-based Provider Enrollment, Chain and Ownership System (PECOS) as an alternative to the paper (CMS-855) enrollment process.
Forms must be completed by all providers of services and suppliers of medical and other health services for enrollment in the Medicare program.
cms-855a (07/11) 1 department of health and human services centers for medicare amp; medicaid services form approved omb no. 0938-0685 who should complete this application
DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE amp; MEDICAID SERVICES Form Approved OMB No. 0938-0685 who Should CoMPlEtE thiS aPPliCation
Here is where you can determine which CMS-855 forms fit your enrollment needs.
CMS is requiring all providers and suppliers that enrolled in Medicare before March 25, 2011, to confirm and certify the accuracy of their enrollment information.
Some of the notable changes on the Form CMS-855 application forms include the following (this list is not exhaustive): Form CMS-855A. A check box was added in Section 2A ...