Transcription of Medicare Enrollment Application - HHS.gov
{{id}} {{{paragraph}}}
Example: biology
Medicare Enrollment Application - HHS.gov
Medicare Enrollment Application Clinics/group Practices and Certain other Suppliers CMS-855B See Page 1 to deterMine if you are CoMPleting the CorreCt Application . See Page 2 for inforMation on where to Mail thiS Application . See Page 35 to find a liSt of the SuPPorting doCuMentation that MuSt Be SuBMitted with thiS Application . DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR Medicare & MEDICAID SERVICES Form Approved OMB NO. 0938-0685 Expires: 08/19 who Should SuBMit thiS Application Clinics and group practices can apply for Enrollment in the Medicare program or make a change in their Enrollment information using either: The Internet-based Provider Enrollment , Chain and Ownership System (PECOS), or The paper Enrollment Application process ( , CMS 855B).
Clinics and group practices can apply for enrollment in the Medicare program or make a change in their enrollment information using either: •The Internet-based Provider Enrollment, Chain and Ownership System (PECOS), or •The paper enrollment application process (e.g., CMS 855B).
Loading..
Tags:
Information
Domain:
Source:
Link to this page:
Please notify us if you found a problem with this document: