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New CMS-855I provider enrollment form debuts

CMS announced in today's MLNConnects that its new version of the CMS-855I provider enrollment form, last revised in July 2011, is now up at the CMS website and available for use. The new version is dated 12/2018.

CMS claims the new version will "reduce provider burden." A quick scan shows some reorganization of the fields, as well as:

  • An extensive "What information is changing?" section for providers reenrollment for that purpose (selections include "Physician Assistant Employment Arrangements" and "Supplier Specific Information");
  • New "Medical Record Correspondence Address" section; 
  • No more "Advanced Diagnostic Imaging (ADI) Suppliers" section;
  • "Practice location information" changed to "Business information";
  • Contact person listing is optional;
  • Some changes in nomenclature (e.g.  "individuals having managing control" is "managing employee"  in the new version).

You can use the new version now; the old version dated 7/2011 will not be accepted after April 30, 2019. 

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