Provider-Based Contact Information
Mailing Address/Contact
All provider-based applications or inquiries are to be directed to your Fiscal Intermediary. Please ensure your cover letter clearly shows the original attestation form is being submitted to WPS and an exact duplicate courtesy copy is being forwarded to the appropriate CMS Regional Office (RO). It is suggested that the provider addresses the letter to WPS and includes appropriate CMS RO as the cc: at the bottom of the letter. This way both WPS and CMS get the same letter that clearly indicates both organizations were copied appropriately. Should you need assistance in obtaining the appropriate Regional Office contact and/or address, please feel free to contact us.
WPS will review for completeness, follow-up on missing information and forward to the appropriate CMS Regional Office with our recommendation.
We have developed an attestation form" that can be found on our Provider Based home web page to assist in the process. It is important that all questions are fully completed and documented. The Fiscal Intermediary is responsible for ensuring all information is submitted to make a sound recommendation to CMS.
Send any provider-based status forms and requests to WPS at one the following addresses:
Delivery/Overnight Service:
WPS
Medicare Audit & Reimbursement
Attn: Audit Technical Support Area - S7
3333 Farnam Street
Suite 700
Omaha, NE 68131
Regular Mail Service:
WPS
Medicare Audit & Reimbursement
Attn: Audit Technical Support Area – 7th floor
P.O. Box 1604
Omaha, NE 68101
Should you have any questions regarding Provider-Based, please contact any Audit Technical Support Supervisor at 1-866-734-9444. Refer to our Provider Enrollment Contacts for names and telephone numbers.
Page Last Updated: Tuesday, 15-Jul-2008 10:37:31 CDT
