CMS Form 855-B alert for ambulance providers

By Mike Swift
President, Kentucky Ambulance Providers Association

GLASGOW — The Kentucky Ambulance Providers Association (KAPA) wants to alert all Kentucky ambulance providers who became Medicare Participating Providers prior to 1996 of their need to obtain, complete and return a Medicare Federal Health Care Provider/Supplier Enrollment Application, Form 855-B prior to the expiration date of their ambulance service license.

According to representatives from AdminaStar-Federal, their receipt of the ambulance provider’s license renewal triggers an internal file search for a completed Form 855-B. If a completed and processed Form 855-B is not on file as required by CMS,  AdminaStar-Federal must suspend the provider’s Medicare reimbursement. AdminaStar-Federal reports that notice was provided of the CMS requirement for completion of the Form 855-B in their February 2002 bulletin. They also advised that they do not notify the provider prior to their license renewal date due to the size of the form and the number of provider’s affected.  Most providers are unaware of this requirement until their Medicare reimbursement is suspended and they make an inquiry.  Once completed and returned to AdminaStar, the processing of the Form 855-B requires some 60-90 days to complete before the provider’s reimbursement suspension is lifted.

A downloadable copy of the Form 855-B (62 pages) can be obtained from the CMS website along with a software program to complete the form.  The web site’s address is www:CMS.gov and you can scroll down to the Ambulance section. The version of the form that Kentucky’s Part B ambulance providers need to download is Form 855-B.

Lindy Lady of AdminaStar-Federal’s External Affairs division will be present at KAPA’s December 18th Board of Directors Meeting at Yellow Ambulance’s Training Center in Louisville, KY to answer Provider’s questions.

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