You may be hearing about different initiatives the Centers for Medicare and Medicaid Services (CMS) are implementing, e.g. revalidation. However, please do not proactively submit a CMS-855 form unless you meet one of the following criteria:

• A change is made to the information supplied on the enrollment application.  Most changes should be submitted within 90 calendar days of when the change occurred.  Changes that must be reported include, but are not limited to, a change in practice location, a change of any managing employee, and a change in billing services.
• Changes in ownership or control must be reported within 30 days.
• For an Independent Diagnostic Testing Facility (IDTF), changes in ownership, changes of locations, changes in general supervision, and adverse legal actions must be reported to Highmark Medicare Service within 30 calendar days of the change.  All other changes must be reported within 90 days.
• A specific request is made by Highmark Medicare Services for a CMS-855 form in order to complete an update to your file.

Please follow these guidelines to assist us in processing valid applications in a timely fashion.  This will also prevent you from completing unnecessary paperwork.

If you are unsure whether a CMS-855 form should be submitted, please call our Customer Service line at 1-866-488-0549 for further assistance.