—Webinar Program—

Medicare Provider Enrollment, PECOS, and the CMS-855

Thursday, September 30, 2010
9:30 a.m. to 11:00 a.m. EDT

At the completion of this program, the participant will be able to:

Understand the CMS Conditions for Payment (CfPs) found at 42 CFR §424.
Appreciate the Medicare concerns surrounding billing and payment for services and supplies.
Review the purpose and use of the five different CMS-855 forms.
Review the purpose and use of the five different CMS-855 forms.
Understand the proper use of the new Internet-based PECOS process.
Appreciate how other required reporting, such as the NPIs and Provider-Based reporting connect with the Medicare enrollment.
Recognize the need to develop organizational resources to maintain multiple CMS-855 forms.
Appreciate current and anticipated changes for maintaining billing privileges with Medicare including revalidation.


I. Conditions for Payment (CfPs)
a. Definitions – Provider vs. Supplier
b. Claims Filing Process
c. Reassignment of Payments
d. Billing Directives
e. OIG Investigations Concerning Fraudulent Billing
f. Revalidation and Billing Credentialing
II. CMS-855 Forms
a. CMS-855-A
b. CMS-855-B
c. CMS-855-I
d. CMS855-R
e. CMS-855-S
f. How the CMS-855 Forms Relate to Each Other
III. Basic Information Requirements and Concerns
a. Who are you?
b. Where you are located?
c. Who owns you?
d. Who manages (controls) you?
IV. PECOS – Provider Enrollment, Chain and Ownership System
a. What is it?
b. How is it used?
c. Who can use it?
d. Special Considerations
V. Addressing Organizational Support
a. NPIs
b. Provider-Based Status
c. CMS-855 Forms
e. Keeping Information Up-to-Date
f. Anticipating CMS Revalidation
g. Other Related Reporting Requirements
VI. Case Studies
VII. Future Requirements for Conditions for Payment

Suggested Participation
Claim filing, coding, billing, compliance, financial, and accreditation and licensing personnel, physicians, non-physician practitioners, DME suppliers, clinics, and other healthcare staff interested in billing privileges with the Medicare program.

Prerequisites for Participating
None. Some understanding of the healthcare billing process and Medicare provider identifier numbers is suggested.

Participation Requirements
You will need a phone (preferably a speakerphone) AND a computer with an Internet connection. If a large group of people will be participating from one location, you may want to have an LCD projector and screen set up as well.

Within a few days of the program, the contact person at each participating site will receive an e-mail from Amy Barnhill ( with instructions and handout materials.

Payment must be received in order to receive program materials.

Registration Fees

FHA members $195*
Non-members $345

*Sites are encouraged to have multiple staff members participate in this program through one registration (utilizing one phone line/computer connection). If your site requires more than one phone line/computer connection multiple registrations are necessary.

Cancellations/Refund Policy
The registration fee, less a $50 processing fee, is refundable only if written notice [e-mail:; fax: (407) 423-4648] is received by 5:00 p.m., Monday, September 27, 2010. Refunds will not be issued for cancellations received after September 27. The refund policy is also applicable to those who indicate payment forthcoming prior to the program.

No refunds will be issued for anyone who does not send written notice of cancellation by September 27, 2010, and the full registration amount will be due and owed to FHA.