Please note that HMS does not have a website for checking the status of Enrollment applications. Beginning with applications received 09/01/08, we will send an acknowledgement letter to the contact person listed on the application letting you know we have received your application within 15 days of receipt. We follow the CMS standards for normal processing time for a new enrollment of 60 days, and a change of information at 45 days. Please do not call our Enrollment Helpline for status inquiries as this ties up the phone lines for those customers who have other issues that need our attention. 

In February 2008 the Centers for Medicare & Medicaid Services (CMS) issued revised the CMS-855 Medicare enrollment applications. Providers and suppliers should begin to use the new forms immediately.  They are available by clicking on the individual form links below or at the CMS website at: http://www.cms.hhs.gov/CMSForms/CMSForms/list.asp.

Please be aware that a significant change in the new forms is the requirement to report a National Provider Identifier (NPI) number.  Also, providers and suppliers not already using Electronic Funds Transfer (EFT) will be required to attach a CMS 588 form to authorize enrollment for EFT with the submission of any CMS 855 enrollment form.

A MLN Matters Article with details on the new 855 enrollment forms can be found at:
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0632.pdf

Information on the National Provider Identifier, including how to enroll, can be found at:
http://www.cms.hhs.gov/NationalProvIdentStand/

A CMS 588 (EFT Authorization) form can be downloaded from the CMS website at:
http://www.cms.hhs.gov/cmsforms/downloads/CMS588.pdf

If you are submitting the CMS 855 form for new enrollment or a change to an existing enrollment record, it must be signed with an original signature and sent via U.S. Mail to:

DCMA
Provider Enrollment Services
Highmark Medicare Services
P.O. Box 890407
Camp Hill, PA 17089-0407

DE
Provider Enrollment Services
Highmark Medicare Services
P.O. Box 890408
Camp Hill, PA 17089-0408

MD
Provider Enrollment Services
Highmark Medicare Services
P.O. Box 890406
Camp Hill, PA 17089-0406

PA
Provider Enrollment Services
Highmark Medicare Services
P.O. Box 890157
Camp Hill, PA 17089-0157

NJ
Provider Enrollment Services
Highmark Medicare Services
P.O. Box 890036
Camp Hill, PA 17089-0036

For more detailed information about filling out the necessary forms for enrollment or changes in the Medicare program, please access the Highmark Medicare Services Part B Reference Manual Chapter 3 - Provider Enrollment.

Questions on the new CMS 855 enrollment forms or the enrollment process can be directed to our Provider Enrollment helpline at 1-866-488-0549.

• Important Provider Enrollment Information
• Enrollment Forms
• Frequently Asked Questions About Enrollment
• National Provider Identifier