Medicare Revalidation Services & PECOS Compliance Management
Billing privileges deactivated due to a missed 5-year revalidation letter? Or stuck in the PECOS portal with pending MAC corrections? We execute emergency electronic reactivations and direct MAC liaison escalations to restore your Medicare billing numbers fast.
Medicare Privilege Rescue
Speak directly with a Senior Medicare Specialist.
The Anatomy of a Medicare Deactivation Emergency
CMS mandates that all Part A, Part B, and DMEPOS providers revalidate enrollment every 5 years. When notices go to outdated addresses or staff miss deadlines, the consequences are immediate and severe.
Instant Claim Rejections
The moment a deactivation date passes, your Medicare PTAN is paused. Every Medicare Part B, Medicare Advantage, and secondary crossover claim is rejected with zero payment remittance.
The 30-Day Retroactive Cap
Under 42 CFR § 424.520, CMS strictly limits back-billing to 30 days before your reactivation application is received by the MAC. Delays in filing cause permanent, unrecoverable revenue write-offs.
Group Reassignment Breaks
When an individual provider deactivates, all CMS-855R group reassignments collapse immediately. The group practice cannot bill under its Type 2 NPI for that provider until full reactivation occurs.
5 Pillars of Our Medicare Revalidation Service
We handle every layer of PECOS data verification, supporting documentation, MAC liaison communications, and claims hold coordination.
CMS-855I & 855R Filings
Full preparation and electronic PECOS web-submission for individual physicians, NPs, PAs, LCSWs, including group reassignments.
CMS-855B Group Revalidations
Complex organizational enrollment updates for single-specialty clinics, multi-specialty medical groups, ASCs, and urgent cares.
Direct MAC Liaison & Escalation
We communicate daily with provider enrollment coordinators at Novitas, Noridian, NGS, Palmetto, WPS, and First Coast.
CMS-588 EFT Bank Updates
Prevent payment suspensions caused by bank changes. We ensure direct deposit authorizations and 1099 TIN matches remain synchronized.
Retroactive Billing Defense
Maximize your retroactive billing effective date, guiding your billing team on managing held claims and preventing clearinghouse denials.
Case Study · Emergency Recovery
A busy cardiology group in FL missed their 5-year Medicare revalidation notice. Their Medicare PTAN numbers were deactivated without warning, freezing $185,000 in monthly Medicare Part B collections. Within 24 hours of engagement, Exp submitted electronic filings. Through daily First Coast coordinator follow-up, full billing privileges were restored in 19 days—preserving 100% of their retroactive billing claims.
Medicare Administrative Contractor (MAC) Matrix
Every MAC operates under distinct operational queues and development guidelines. We navigate all regional contractors daily.
| Medicare Contractor (MAC) | Jurisdiction Codes | States Covered | Typical MAC Queue | Exp Expedited Time |
|---|---|---|---|---|
| Noridian Healthcare Solutions | JE & JF | CA, NV, HI, AZ, WA, OR, ID, MT, ND, SD, UT, WY, AK | 60–90 Days (Paper) | 14–25 Days (PECOS Web) |
| Novitas Solutions | JH & JL | TX, AR, LA, OK, CO, NM, PA, NJ, MD, DE, DC | 60–75 Days | 15–28 Days |
| National Government Services (NGS) | J6 & JK | NY, CT, MA, RI, VT, ME, NH, IL, MN, WI | 60–90 Days | 15–30 Days |
| Palmetto GBA | JJ & JM | GA, NC, SC, TN, VA, WV, AL | 45–75 Days | 14–24 Days |
| WPS Government Health | J5 & J8 | IN, MI, IA, KS, MO, NE | 60–80 Days | 15–28 Days |
| First Coast Service Options (FCSO) | JN | FL, PR, USVI | 60–90 Days | 15–30 Days |
Our 4-Phase Medicare Reactivation Protocol
When billing privileges are down, every hour matters. Here is how we take you from deactivation to active billing status.
Status Triage & Audit
We query PECOS, determine the exact deactivation trigger date, verify NPI/TIN alignment, and calculate your 30-day retroactive billing window.
Application Prep & Signing
We draft complete CMS-855 electronic packets, upload required licenses, and coordinate digital provider signature.
Direct MAC Follow-Up
We obtain your Document Control Number (DCN) within 48 hours and conduct direct coordinator outreach to bypass standard wait queues.
PTAN Active & Claim Release
Upon receiving your MAC approval letter, we verify PTAN activation in PECOS and give your billing team the green light to release back-claims.
Medicare Revalidation & Reactivation FAQs
Everything you need to know about protecting your Medicare billing numbers.
How long does an emergency Medicare reactivation take?
Can we back-bill Medicare for claims incurred during the deactivation gap?
What is the difference between a Medicare deactivation and a revocation?
How do I know when my 5-year Medicare revalidation is due?
What happens to group reassignments (CMS-855R) during an individual deactivation?
Do we need to update our Electronic Funds Transfer (CMS-588) during revalidation?
Which Medicare Administrative Contractor (MAC) processes my reactivation?
How does Exp prevent Medicare revalidation deactivations before they happen?
Restore Your Medicare Billing Privileges Immediately
Do not let a missed revalidation stall your practice revenue. Let our dedicated Medicare enrollment team submit your PECOS filing within 24 hours.