When a physician or other practitioner is no longer part of your practice, it’s important to update the group’s enrollment records. This will protect against potential problems related to billing.

There are 5 steps to follow when terminating a former employee’s reassignment of Medicare Benefits. Keep in mind that the provider’s signature is not needed.

The Reassignment of Medicare Benefits form, CMS-855R can be completed for this task, though the provider is ultimately responsible for his or her enrollment record. This is important to discuss with the doctor or non-physician practitioner upon the exit interview.

The provider’s National Provider Identifier (NPI) number can be found with your group’s Provider Transaction Account Number (PTAN). It’s an authentication number that your carrier uses.

Here are the 5 steps to terminating a reassignment, using the 855R:

1. On page 3, check the “You are an organization” box. Enter the effective date, which is the date the physician left the practice.
2. On page 4, enter the business name, Tax ID Number (TIN), Medicare ID Number and NPI.
3. In section 3 of page 4, fill in the provider information.
4. On page 5, fill in the information and sign section 4B. Keep in mind that reassignment applications between a provider and a new group must be signed by both parties, but termination of reassignment needs only one signature.
5. On page 6, fill in the Contact Person portion. That person will receive a tracking number and confirmation notice when the application is processed.

This is the information needed to tell your carrier that the provider is no longer with your group, and claims of service dated up to that effective date will be paid.

You should note, though, that a reassignment application that’s completed with the doctor’s new group won’t remove that physician from your record.
You also can complete a termination through the CMS online Provider Enrollment, Chain and Ownership System (PECOS).

Keep these things in mind:

• Updating the reassignment is important to keep enrollment records current.
• This helps prevent fraud, as it prevents a group from using the NPI to bill for services.
• CMS allows a “locum tenens” provider to be used up to 60 days when a physician leaves the group.
• Get the physician’s permission, in writing, to continue using the provider’s NPI with the Q6 modifier. These are services provided by a “locum tenens” physician.
• The provider is required to change the National Plan and Provider Enumeration System (NPPES) login and password. That removes the former employer from access to his or her records.