CMS-855-A & B for Hospitals and Clinics

Event Information
Product Format
Prerecorded Event
90 minutes
Product Description

Demystifying the Big and Complicated CMS-855-A – Know What Does CMS Really Want to Know!

The big and complicated CMS-855-A is used by providers to apply for enrollment in the Medicare program or make a change in their enrollment information. CMS-855-A is used for paper enrollment while PECOS is used for online filing of forms.

In this webinar by nationally renowned speaker Duane Abbey, Ph.D., you will be able to appreciate the CMS Forms 855-A & B along with the six different variations and understand the process of obtaining and maintaining billing privileges for Medicare. During the 90-min session you’ll review the data elements and information requirement for the CMS-855-A and 855-B. You will understand how the CMS 855-A relates to the CMS 855-B; recognize the need for CMS to gather appropriate information concerning ownership, management and operations for billing purposes; and understand how the NPIs and other reporting requirements affect both the CMS-855-A &B.

Attending this session will help you appreciate the use of the other CMS-855 forms relative to the CMS-855-A & B. Also, you will be able to recognize the need to develop organizational resources to maintain multiple CMS Form 855-A along with multiple 855-B forms. Additionally, Dr. Abbey will review and explain the use of PECOS for Internet-based filing of the CMS-855 forms and provide an overview of anticipated changes for maintaining billing privileges with Medicare.

Get answers to questions such as:

  • Why is the CMS-855-A so big and complicated?
  • What does CMS really want to know?
  • When should the CMS-855-B be used?
  • What is the relationship, if any, between the CMS-855-A and the CMS-855-B?
  • Do we need to indicate our off-campus provider-based clinics on the CMS-855-A?
  • Do we really have to provide the Social Security numbers for our hospital board members?
  • How many different CMS-855-A and CMS-855-B forms do we need to file?
  • How often do we need to update the CMS-855 forms?
  • Do our Tax Identification Numbers (TINs) make a difference?
  • Who can know everything that is going on at our hospital and clinics?
  • What kinds of compliance implications are present with the CMS-855 forms?

Topics covered in the session:

  • CMS Billing Privileges
    • Overview of 42 CFR §424
    • CMS Concerns Surrounding Billing Privileges
    • OIG Investigations Concerning Fraudulent Billing
  • The CMS Form 855
    • Six Different Forms
    • Use and Relationship of Forms
    • Basic Information Required
  • The CMS Form 855-A
    • Hospital Billing Privileges
    • Key Information
      • Type of Entity
      • Ownership
      • Management Control
      • Financial Control
    • Need to File and Maintain Multiple CMS 855 Forms
    • Organizational Structuring to Report Changes and Maintain the CMS-855 Forms
  • The CMS Form 855-B
    • Clinic and Group Practice Billing Privileges
    • Key Information
      • Type of Entity
      • Ownership
      • Management Control
      • Financial Control
    • Need to File and Maintain Multiple CMS 855 Forms
    • Organizational Structuring to Report Changes and Maintain the CMS-855 Forms
  • NPIs (National Provider Identifiers)
    • Intents and Benefits of the Program
    • Analyzing Business Structures
  • Tax Identification Numbers (TINs)
    • Business Structuring
    • Relationship of TINs
  • Related Issues
    • Provider-Based Clinics
    • Ambulatory Surgical Centers
    • Ambulance
    • Verification Processes
    • Common Problem Areas
  • Future Requirements for Conditions for Payment
    • Hospital Use of PECOS (Provider Enrollment, Chain and Ownership System)
    • Special Compliance Concerns
  • Case Studies and Examples

Who should attend

Claim Filing Personnel, Coding and Billing Personnel, Compliance Personnel, Financial Personnel, Accreditation and Licensing Personnel, Other Personnel Interested in Billing Privileges with the Medicare Program

Order Below or Call 1-844-384-4744 Today

We Also Recommend
Order Form

(Select the format below)

Choose Quantity:

(*) Single User Price

You can also order through:




About Our Speaker

Duane Abbey Hospital Coding & Compliance Expert

 Duane C. Abbey, Ph.D. is a management consultant and president of Abbey & Abbey, Consultants, Inc., which specializes in healthcare consulting and related areas. Duane earned his graduate degrees at the University of Notre Dame and Iowa State University and has more than 20 years of experience as a consultant. He performs various types of financial analysis involving business structuring, organizational development, enrolment and other financially related concerns of organizations....   More Info
More Events By The Speaker

Why ProfEdOnDemand?
  • Save money on travel.
  • Meet your specific training needs.
  • Keep learning after the event.
  • Save time training your whole staff.
Join Our Mailing List