Portable X-Ray

APPLY FOR CERTIFICATION AS A PORTABLE X-RAY SUPPLIER:

It is critical to begin the process by submitting an application for Medicare enrollment through the designated MAC (Medicare Administrative Contractor). This is generally a lengthy process and must be completed before the State Agency and CMS can continue with certification. To apply for enrollment, the applicant must have an assigned NPI (National Provider Identifier) issued by the National Plan and Provider Enumeration System (NPPES).

The MAC for Portable X-Ray Suppliers in Louisiana is Novitas Solutions. The Novitas website provides options for enrolling online and/or by mail.

The Application for Medicare Enrollment for Portable X-Ray Suppliers is the 855B (which may also be accessed through the Novitas website).

Once notification of an approved reccommendation for enrollment has been recieved from Novitas (i.e., the "MAC Recommendation Letter"), the process can continue. Although Novitas will issue a copy of the letter and the completed 855B to the State Agendy (SA) directly, the supplier may wish to submit to SA a copy of the letter received, with the completed Application for Certification (form CMS1880) and a Letter of Intent.

PRIORITY EXCEPTION REQUEST:

Providers or suppliers may apply to CMS via the State Survey Agency requesting consideration for an exception to the priority assignment of the initial survey if lack of Medicare certification would cause significant access-to-care problems for beneficiaries served by the provider or supplier. There is no speial form required to make a priority request. However, the burden is on the applicant to provide data and other evidence that effectively establishes the probability of serious, adverse beneficiary healthcare access consequences if the provider is not enrolled to participate in Medicare.

CHECKLIST OF DOCEMENTS TO BE SUBMITTED

The documents required to schedule an initial certification survey should be submitted to:

DHH-Health Standards

Portable X-Ray

P.O. Box 3767

Baton Rouge, LA 70821-3767