Is the 9-digit zip code required on the 855A form?
A3 – Yes. The provider must submit a 9-digit zip code for all locations listed on the CMS 855A form. If a section of the 855A form does not contain the full 9-digit zip code, the contractor will request the appropriate sections be revised and resubmitted. Q4 – Can a provider submit more than one Authorized Official? A4 – Yes, as long as each authorized official meets the definition stated in Pub 100-08 PIM Chapter 10 section 1.1. The provider will also need to submit a section 6 for each authorized official on the CMS 855A form.<> Q5 – Can a provider change the Administrator, Director, CEO as the primary contact person for correspondence with a request letter or phone call? A5 – No, a provider will have to submit a CMS 855A application to change “Ownership Interest/Managing Control Information (Individuals).” A provider will need to submit a section 6 for each individual that no longer has ownership interest and managing control (check delete and effective date) and a section 6 for eac
