Wyoming - Get Certification in the Medicare and (or) Medicaid Program to Provide Outpatient Physical Therapy and (or) Speech Pathology Services

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Procedure

Apply In-Person:

1. The applicant has to reach out to department of health and human services Centres for Medicare & Medicaid services for the application. Contact details are mentioned in “Office Locations & Contacts” of this page. Or the given following Contact Link
2. An application form is also available at the following Link
3. The applicant should make sure to carry all the documents that are mentioned under the “Required Documents” section of this page (Both photocopies and originals).
4. Applicant has to fill in all the necessary details in the form and attach the photocopies of the documents that are needed along with the application form before submitting.
5. The fee for this procedure has been mentioned under the “Fees” section of this page.
6. Submitting this form will begin the process of determining whether or not the participation requirements have been met.
7. Even if some information is currently unavailable, do not hesitate in returning the form.
8. The State agency can assist the applicant with the form's completion.
9. As of today's date, respond to all questions. Return the original and first two copies in the envelope given to the State agency; keep the last copy for their records.
10. The name and location of the State agency might be learned from the local Social Security office if a return envelope is not included.

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Required Documents

• Application form
• Two copies of the form to the State agency
• All Medicare requirement document (if needed)

Office Locations & Contacts

Location: Maryland
Address:
Centers For Medicare & Medicaid Services (CMS)
7500 Security Boulevard, Baltimore, MD 21244
Medicare Service Center: 800-MEDICARE (800-633-4227)
Medicare Service Center TTY: 877-486-2048
Report Medicare Fraud & Abuse: 800-HHS-TIPS (1-800-447-8477)
Social Security: 800-772-1213
Contact Link

CMS Regional Office:
Contact Link
Contact Link

Local Office:
Contact Link

Note:
Provide Zip code to find Social Security Office to contact State agency.

Eligibility

• Rehabilitation Agency
• Clinic
• Public Health Agency

Fees

• Payment is dependent on the certification of the plan of care rather than the order.
• For fee details, the applicant has to contact the CMS agency.

Validity

• Recertification Timeline – Continued or Modified Therapy
  • Should be signed whenever the necessity for a significant revision of the plan becomes apparent, or at least every 90 days after the plan's beginning of treatment, unless they are postponed.

Documents to Use

• An application form is available at the following Link

Sample Documents

Please attach sample completed documents that would help other people.

Processing Time

• While submitting the form in the office, the authority will intimate the processing time to the applicant.

Related Videos

Videos explaining the procedure or to fill the applications.
Attach videos using the following tag <&video type='website'>video ID|width|height<&/video&>
from external websites.
Please remove the '&' inside the emptags during implementation.
Website = allocine, blip, dailymotion, facebook, gametrailers, googlevideo, html5, metacafe, myspace, revver,
sevenload, viddler, vimeo, youku, youtube
width = 560, height = 340, Video ID = Can be obtained from the URL of webpage where the video is displayed.
e.gIn the following url 'http://www.youtube.com/watch?v=Y0US7oR_t3M' Video ID is 'Y0US7oR_t3M'.

Instructions

• The surveyor will bring this form to the resurvey and either request that a facility representative complete, sign, date, and return it at the end of the onsite visit, after which the surveyor will review it for accuracy and completeness; or the surveyor may complete the form and have the facility representative review and sign it.
• After the facility representative's signature, the surveyor will initial in either situation.

Required Information

The information needed to be filled in the application form are listed below:

• Request To Establish Eligibility In
• Medicare/Medicaid Provider Number
• State/County
• State Region
• Identifying Information
• Services Provided
• Type Of Organization
• Type Of Control
• Physical Therapists
• Speech Pathologists
• Occupational Therapists

Need for the Document

• Organization who want to provide Medicare and (or) Medicaid Program to Provide Outpatient Physical Therapy and (or) Speech Pathology Services must need a certificate to run.

Information which might help

• For more information Link

Other uses of the Document/Certificate

• The documents are also used by the State Agency to assess the cumulative records of actual services supplied.
• The utilisation statistics for various services will be displayed on the work schedules of personnel providing services.

External Links

Place some external links which might help.

Others

More information which might help people.