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SKILLED NURSING FACILITY
You should promptly contact your fiscal intermediary of preference. They will provide you with a CMS-855A Enrollment Application. They will also answer any questions you have about completion of the application and the enrollment process. You should promptly complete and submit the application to the fiscal intermediary.
You should promptly and simultaneously contact the local State Agency which handles your provider type. If you cannot find the state agency contact from our listing, then contact your provider association, your preferred fiscal intermediary, or check your local telephone directory. Your state agency will provide you with any additional forms and information they require. They will also assist you if you desire Medicaid enrollment. Do not submit your CMS-855A to the state agency.
After the fiscal intermediary has recommended you for approval, the state agency will conduct a state survey. The approximate processing time for the fiscal intermediary review of your application is 60 days from receipt of your application. However, this assumes that you promptly provide the fiscal intermediary with any required information that they request. If you pass the state survey, the local CMS regional office will contact you concerning issuance of a formal signed provider agreement. Upon completion of the agreement, you will be given a provider number and be permitted to submit billings.
If you have already submitted an application and have a problem with the fiscal intermediary, you should contact the CMS Regional Office in the state where the fiscal intermediary is located. The Regional Office has responsibility for monitoring the fiscal intermediary performance and will be glad to assist you.
