Medicare and Medicaid Contracting

Why Do I Need to Do Medicare Revalidation and Enrollment?

In order to have Medicare billing privileges, physicians are required to have an active contract with their local Medicare contractor. They need to maintain active PECOS account as well for efficient communication and faster contracting. Medicare also requires providers to revalidate their contracts every five years. If provider fails to revalidate, he/she will lose Medicare billing privilege and have to start a new application process.

Do Physicians Need to be Enrolled with Mediciad?

Providers who want to participate with state healthcare programs must be contracted with state specific Medicaid. If a provider is not contracted, no claim for that provider will receive payment. Private medical practices will enroll with traditional fee-for-service with Medicaid. Providers will need to enroll through their local Medicaid portals. This is the best way to communicate with provider services. State Medicaid will also require periodic revalidation. Timing for revalidation is state specific. Requirements are also state specific.

We can take away the headache of dealing with complicated insurance requirements and ensure all contracts are active and all information is updated. We have extensive experience with enrollment and revalidation for Medicare and Medicaid. We can help providers create PECOS and Medicaid accounts and submit and process all applications.  We keep constant contact with all insurance Provider Service departments to keep updates on applications and requirements.


Medicare Revalidation

Who We Work With


Medicare revalidation is the renewal of Medicare contract. For private practices, contracts need to be revalidated every five years. Through revalidation, Medicare ensures it has updated information from providers.


PECOS (Provider Enrollment, Chain, and Ownership System) is the online portal for Medicare. PECOS makes communication with Medicare very efficient.


MS 855B form is used for Medicare enrollment application by clinics, group practices, and physicians.


855R form is used for Reassignment of benefit for Medicare providers. Practitioners who want to direct Medicare payments to an entity will use this form.


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