Northern California Physicians: Are Medicare Payments to Your Group At Risk?
[Posted 05/12/08]

Medicare payments to some Northern California groups are at risk.  According to NHIC, as many as 5,000 physicians who work for groups or contract with groups in Northern California must update the required 855R form, which reassigns their Medicare payment to their group(s).  Until an updated 855R form is filled out and submitted for each of the groups for which a physician bills, that group will not get paid for the physician’s Medicare services after June 1.  This impacts groups of all sizes.   

To avoid payment problems, CMA strongly urges all physicians who work for groups or contract with groups in Northern California to contact the NHIC hotline at 1-877-527-6613 to ensure that you have filled out the required 855R form for each of the groups to which you want to reassign your Medicare payments.   For those physicians who enrolled as Medicare providers prior to 2006, you should also check to ensure you have filled out the 855I form in order to update your records. 

Groups may be able to assist physicians in filling out these forms, but the physician must sign them.  To complete the 855R, physicians will need their NPI, the Tax ID # for each of the groups to whom they want to assign payments for their Medicare services, and the signature of the groups’ authorizing agent.

CMS provider enrollment forms can be downloaded at http://www.medicarenhic.com/cal_prov/enroll_forms.shtml

Contact: Frank Navarro, 888/401-5911 or Gfonseca@cmanet.org