5 Ways To Fill Out 855r Form For Medicare

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The Centers for Medicare and Medicaid Services (CMS) requires healthcare providers to complete the 855R form as part of the Medicare reassignment of benefits process. This form allows healthcare providers to reassign their Medicare benefits to another party, such as a medical billing company or a supplier. Filling out the 855R form correctly is crucial to ensure timely and accurate payment of Medicare claims. Here are five ways to fill out the 855R form for Medicare:

Understanding the 855R Form Requirements

Before filling out the 855R form, it's essential to understand the requirements and guidelines set by CMS. The form consists of several sections, including provider information, reassignment information, and certification statements. Healthcare providers must ensure they meet the necessary requirements, such as having a valid National Provider Identifier (NPI) and a Medicare provider agreement.

Section 1: Provider Information

In this section, healthcare providers must enter their name, address, and NPI. It's crucial to ensure the information is accurate and up-to-date, as any errors may delay or reject the form.

Section 2: Reassignment Information

This section requires healthcare providers to enter the name, address, and NPI of the party they are reassigning their Medicare benefits to. Providers must also specify the type of reassignment, such as a medical billing company or a supplier.

Section 3: Certification Statements

Healthcare providers must sign and date the form, certifying that they are reassigning their Medicare benefits to the specified party. Providers must also acknowledge that they understand the terms and conditions of the reassignment.

5 Ways to Fill Out the 855R Form

Here are five ways to fill out the 855R form:

1. Manual Completion: Healthcare providers can manually complete the 855R form by downloading it from the CMS website or obtaining a copy from their Medicare Administrative Contractor (MAC). Providers must ensure they fill out the form accurately and legibly.
2. Electronic Submission: CMS offers an electronic submission option for the 855R form through the Medicare Provider Enrollment, Chain, and Ownership System (PECOS). Providers must register for a PECOS account and follow the online instructions to complete and submit the form.
3. PECOS Web Interface: The PECOS web interface allows healthcare providers to complete and submit the 855R form online. Providers must log in to their PECOS account and follow the prompts to fill out the form.
4. PECOS Fax Cover Sheet: Providers can also complete the 855R form manually and fax it to their MAC using a PECOS fax cover sheet. The fax cover sheet must include the provider's NPI and the name of the MAC.
5. Authorized Agent: Healthcare providers can authorize an agent, such as a medical billing company or a supplier, to complete and submit the 855R form on their behalf. The authorized agent must have a valid power of attorney or written authorization from the provider.

Common Mistakes to Avoid

When filling out the 855R form, healthcare providers must avoid common mistakes that can delay or reject the form. These mistakes include:

• Incomplete or inaccurate provider information
• Incorrect or missing reassignment information
• Failure to sign and date the form
• Incomplete or missing certification statements
• Using an outdated or incorrect form version

Benefits of Accurate 855R Form Completion

Accurate completion of the 855R form ensures timely and accurate payment of Medicare claims. Benefits of accurate completion include:

• Reduced claim denials and rejections
• Faster claim processing and payment
• Improved provider-patient relationships
• Reduced administrative burdens
• Compliance with Medicare regulations

Conclusion

Filling out the 855R form correctly is crucial for healthcare providers to reassign their Medicare benefits accurately. By understanding the form requirements, avoiding common mistakes, and using the correct completion methods, providers can ensure timely and accurate payment of Medicare claims. If you have any questions or concerns about filling out the 855R form, please comment below or share this article with your colleagues.