Información de la aplicación del centro de pruebas de diagnóstico independiente
De acuerdo con el Título 42, CFR, Sección 410.33, Centros de Servicios de Medicare y Medicaid, y el Manual Estatal de Medicaid, Secciones 3490 a 3490.14, Los proveedores de centros independientes de pruebas de diagnóstico (IDTF, por sus siglas en inglés) solo pueden inscribir en el Program Medi-Cal como proveedores "solo de cobertura cruzada Medicare " para recibir el reembolso por los servicios de la Parte B Medicare .
Independent Diagnostic Testing Facilities are required to submit their application via PAVE (Provider Application and Validation for Enrollment).
1. Federal Employer Identification Number (FEIN) or Individual Taxpayer Identification Number (ITIN) verification, if a social security number is not used, by submitting a current Internal Revenue Service (IRS) generated document. The only acceptable documents include an IRS-generated Letter 147-C, IRS-generated Form 941 (Employer’s Quarterly Federal Tax Return), IRS-generated Form 8109-C (Deposit Coupon), or IRS-generated Form SS-4 (only the official Confirmation Notification of FEIN/ITIN assignment). Note: The legal name of the applicant or provider on the application must exactly match the name on the IRS-generated document; and the applicant/provider must be an owner or officer of the entity listed on the IRS document. For further information, please visit the IRS or call them at (800) 829-4933.
2. Copy of approval letter as an Independent Diagnostic Testing Facility (IDTF) provider from the Centers of Medicare and Medicaid Services (CMS).