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Become a Centralized Biller

Guidance for becoming a centralized biller

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: October 24, 2016

To become a centralized biller, you must complete the entire enrollment process and get CMS Central Office's (CO) and the designated MAC’s participation approval. Apply early because enrolling as a centralized biller takes 8 to 12 weeks.

You must reapply to the CMS CO for approval each year by June 1. Approval for centralized billing is limited to the 12-month period from September 1 thru August 31 of the next year.

Contact the CMS CO in writing by June 1 of the year you plan to begin centralized billing. Send requests for enrollment or renewal as a centralized biller to Bridgitte Davis-Hawkins at the following address:

Centers for Medicare & Medicaid Services
Division of Practitioner Claims Processing
Provider Billing Group
7500 Security Boulevard
Mail Stop C4-10-07
Baltimore, MD 21244

 

Required Information

Include all the information below in your written request:

  • Estimate how many patients will get flu shots
  • Estimate how many patients will get pneumococcal shots
  • Approximate dates you will give the shots
  • List of states where you will hold flu and pneumococcal shot clinics
  • Type of services you generally deliver (for example, ambulance, home health, or visiting nurse)
  • If you employ the nurses who will give the flu and pneumococcal shot or if you hire them specifically to give these shots
  • Names and addresses of all entities operating under your application
  • Contact information for the centralized billing program designated contact

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.