How long will it take R.J. Hedges to complete the application?

Our Medicare Application Team can complete all necessary items in 5-7 business days, once we have:

• Received the online questionnaire

• Verified payment through Stripe

• Reviewed your submitted documents

• Received answers to any of our clarification questions or requests for amended documents.

   

How is the application completed?

Our Medicare Application Team will:

• Access the Physicians PECOS from the surrogacy granted  to our parent company, Connecture, Inc., via the Medicare  I&A System.
  
  
• Build out your application for the  CMS-855s on PECOS.
  
  
• Provide necessary Policy & Procedure documents, support documents, forms, instructions, and checklists to prepare for the on-site inspection from CMS.
  
  
• Provide ongoing support through the PTAN process, up to and including the date the PTAN is awarded. Additional fees may apply if requirements are not followed or if corrections/resubmissions are needed due to things not being completed in a timely manner. 

Physician Responsibilities & Delegated Tasks

Most parts of the PTAN application can be delegated to an office manager or staff member. However, the physician, authorized official, and owners tied to the EIN still have required responsibilities.

Tasks That May Be Delegated:

• Complete the online questionnaire.
• Upload supporting documents.
• Work with our Project Manager to provide missing information.
• Prepare for the CMS onsite visit.

Tasks That Require Physician, Authorized Official, or Owner Involvement:

• The Authorized Official process payment and e-sign through PECOS.
• All owners must be available for fingerprinting if requested by Accurate Biometics.
• Fingerprinting must be completed at an Accurate Biometrics- verified location.

Important Note:

The PTAN must be awarded before dispensing or billing can begin.

Additional fees may apply if instructions are not followed, requested information is delayed, or corrections are needed due to incomplete, inaccurate, or improperly submitted documentation.

Do I have to update things in the future?

• Anytime there is a change of address, ownership, name, delegated officials, authorized, etc., the Medicare application will need to be updated through PECOS.
  
  
• Medicare also requires revalidations every three years.
  
  
• Any updates or changes can be made through PECOS by your authorized officials, or contact us to assist for an hourly fee.

1. Set up your CMS Identity & Access Management System (I&A), if you already have it, add our parent company Connecture, as a surrogate
2. IRS Document showing EIN
3. Certificate of Liability
4. Facility NPI
5. Ownership Type (Corporation or Individuals)
6. Owners full name, DOB, SS#, Country and State of birth, Ownership Effective Date, W-2 from the past tax year
7. Banking information, including your local bank’s name and address, contact person at the bank, and a voided check with Legal Business Name as it appears on IRS Document
8. Billing information – Billing Company Name, Address, EIN, Phone #

Provider Expectations for CMS Applications

At RJH, we are here to guide and support your application process to obtain a Medicare PTAN, which is required to bill for DME (Durable Medical Equipment) items such as surgical dressings and wound care supplies. While we handle the preparation and offer expert guidance, your active participation is essential to successfully complete the process.

What We Do (and Don’t Do)

We do not issue DME licenses. Our role is to assist with the preparation of your CMS PTAN application, not to grant licensure.  You are responsible for ensuring that you meet your state’s DME licensure requirements.   Please check the NPWest DMEPOS Licensure Database and confirm licensing needs for S01 Surgical Dressings or any other DME categories you wish to provide.

Timely Communication is Essential

• You must respond to all document and support requests from the RJH team within 2 business days.
  • Delayed responses will extend your application timeline.
• Email and mail from Medicare contractors (Palmetto or Novitas) must be reviewed and responded to immediately.
  • Time-sensitive documents may arrive via USPS—do not discard unopened envelopes.

Understanding the Timeline

• Initial PECOS application reviews by Medicare contractors can take up to 6 months.
  • Additional documentation requests may cause further delays.
• Contractor regions:
  • East of the Mississippi River – Processed by Novitas
  • West of the Mississippi River – Processed by Palmetto

If Additional Documentation is Requested by CMS

• Common requests may include:
  • Updated licenses
  • Supporting documents
  • Fingerprinting
• You have only 30 days from the request date to provide missing items to CMS.
  • Missed deadlines may result in application denial, triggering a lengthy appeal process and additional fees.
• Please forward all CMS correspondence to your assigned RJH Medicare Application Specialist as soon as possible.

Fingerprinting (If Applicable)

• CMS may request fingerprints from providers or facility owners as a one-time identity verification.
  • If you’ve already been fingerprinted for CMS in the past, this step may not be required.

Timeline will not start until RJH Receives Completed Questionnaire, Access to I&A, and Payment

We are committed to guiding you through this process and handling the heavy lifting—but your timely participation is essential.  Delays in providing required documentation can extend the timeline by weeks or months. IMPORTANT: Your timeline begins only after RJH has received all the following:

1. Completed RJH Questionnaire with all supporting documents
2. Surrogate access to your I&A (Identity & Access) account
3. Payment for RJH services

Day 1 – Application Preparation Begins

1. Once completed questionnaire is received, RJH reviews your completed questionnaire and verifies access to your I&A account.
2. If anything is missing or incomplete, RJH will send a follow-up request to the Contact Person for additional information.

By Day 10 – Application Submission

1. RJH completes the online PECOS application and submits to Medicare.
2. This officially starts the clock for CMS to review your application.
3. At this stage, the client must:
   1. Pay the PECOS application fee 
   2. Have your Authorized or Delegated Official electronically sign the application
   3. Submit the Application via PECOS, and wait for feedback from CMS.

After Day 10 – Compliance Tasks & Monitoring

While CMS reviews your application, you must complete the following tasks:

1. Implementation Checklists

   1. Complete the On-Site Inspection Checklist (Portal) and RJH Implementation Checklist

   2. Order and receive sample DME items (e.g., surgical dressings) to have on-site before inspection. We recommend ordering early from your supplier to avoid delays.

2. Monitoring for CMS Communication

   1. Your designated Contact Person, as listed in PECOS, must monitor email and USPS mail daily for any communication from Palmetto or Novitas.

      1. Respond immediately to any requests.

      2. Never discard unopened mail—important documents often arrive by USPS.

3. Fingerprint Requests (if applicable)

   1. CMS may request fingerprints from owners or providers. This is a one-time request.

      1. If you've previously completed CMS fingerprinting, you may not need to repeat it.

4. Unannounced On-Site Inspection

   1. At any point after submission, CMS may conduct an unannounced inspection. To prepare:

      1. Train your staff to immediately direct the inspector to the appropriate contact.

      2. Inspectors carry official badges—verify their ID and record their name for your records.

5. Final Notes

   1. CMS review timelines vary by region and volume. It is not uncommon for initial reviews to take up to 6 months or longer.

   2. Missed deadlines or incomplete responses to CMS will delay your PTAN and may require an appeal process and in some instances a full re-application process (with additional fees). Please be  

  Frequently Asked Questions

If you need to consult with your business partner(s)- here's a flyer to print or email to them Physician PTAN Flyer

If you need to work through some details with us- click to schedule time to meet with one of our Compliance Consultants

If your ready to move forward now- fill out the 3 questions below, Click the Yellow "Get Started" to go to our online order form and questionnaire.  Be sure to create a user name and password to save your progress.  Payment is only due when you finish and submit the online form.