Form CMS-855O Medicare Enrollment Application - Registration for Eligible Ordering and Referring Physicians and Non-physician Practitioners

Form CMS-855O Medicare Enrollment Application - Registration for Eligible Ordering and Referring Physicians and Non-physician Practitioners

What Is Form CMS-855O?

This is a legal form that was released by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services on July 1, 2022 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form CMS-855O?
A: Form CMS-855O is the Medicare Enrollment Application for Eligible Ordering and Referring Physicians and Non-physician Practitioners.

Q: Who should use Form CMS-855O?
A: Eligible ordering and referring physicians and non-physician practitioners should use Form CMS-855O.

Q: What is the purpose of Form CMS-855O?
A: The purpose of Form CMS-855O is to enroll in Medicare and be able to order and refer services for Medicare beneficiaries.

Q: What information is required on Form CMS-855O?
A: Form CMS-855O requires information such as personal and contact information, professional credentials, and any applicable supporting documentation.

Q: Are there any fees associated with submitting Form CMS-855O?
A: No, there are no fees associated with submitting Form CMS-855O.

Q: What happens after submitting Form CMS-855O?
A: After submitting Form CMS-855O, your application will be reviewed by Medicare to ensure eligibility. Once approved, you will be able to order and refer services for Medicare beneficiaries.

Q: How long does it take to process Form CMS-855O?
A: The processing time for Form CMS-855O can vary, but it generally takes around 60 days to receive a decision from Medicare.

Q: Can I make updates to my information after submitting Form CMS-855O?
A: Yes, you can make updates to your information by submitting a new Form CMS-855O or by contacting your Medicare Administrative Contractor (MAC).

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Form Details:

  • Released on July 1, 2022;
  • The latest available edition released by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CMS-855O by clicking the link below or browse more documents and templates provided by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services.

Download Form CMS-855O Medicare Enrollment Application - Registration for Eligible Ordering and Referring Physicians and Non-physician Practitioners

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  • Form CMS-855O Medicare Enrollment Application - Registration for Eligible Ordering and Referring Physicians and Non-physician Practitioners

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