United States - Get Certification as a supplier of portable X-Ray Service

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Procedure

Apply In Person:

1. To Get Certification as a supplier of portable X-Ray Service, the applicant has to approach the U.S. Medicare & Medicaid services state Agency link
2. An application form will be provided to the applicant by the concerned officer. or it can be downloaded from the following link
3. The applicant has to fill in all the necessary details in the application form. (Incomplete applications are not accepted)
4. Make sure that the applicant has attached all the necessary documents that are mentioned in the “Required Documents” section of this page.
5. The applicant has to attach the photocopies of the required documents along with the application form while submitting.
6. Submit all the documents with the completed form to the concerned office.
7. After receiving the application, the concerned authority will check the submitted application and document set. If all are in place, the application will be accepted.
8. An acknowledgment receipt will be provided. Please save it for future reference.
9. Then the application will be processed further. All the updates on the application status will be sent via SMS to the applicant’s mobile number.
10. Once the process gets completed, the applicant gets a call from the office regarding the application.
11. This entire process can be completed within 30 - 40 days or as per the timeline advised by the respective department authority.

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Required Documents

• Application form link
• Two copies of the form to the State agency
• All Medicare requirement document (if needed)

Office Locations & Contacts

Centers For Medicare & Medicaid Services (CMS)
7500 Security Boulevard, Baltimore, MD 21244
Medicare Service Center: 800-MEDICARE (800-633-4227)
Medicare Service Center TTY: 877-486-2048
Report Medicare Fraud & Abuse: 800-HHS-TIPS (1-800-447-8477)
Social Security: 800-772-1213
Contact link
Regional link

Eligibility

• The applicant as graduated from a physical therapy curriculum.
• The medical services of the clinic are provided by a group of physicians.
• Physician is present in the clinic at all times to perform medical (rather than administrative) services.
• The applicant has 2 years of appropriate experience as a physical therapist and has achieved a satisfactory grade on a proficiency examination approved by the Secretary, except that such determinations of proficiency shall not apply with respect to persons initially licensed by a State or seeking qualification as a physical therapist.
• The applicant has 15 years of full-time experience in the treatment of illness or injury through the practice of physical therapy.
• For more details see instructions in the application.

Fees

• Fee for this procedure has to be paid as per the authority request.

Validity

Explain the time until which the certificate/document is valid.
e.g. Birth Certificate Valid Forever

Documents to Use

• Application form link

Sample Documents

Please attach sample completed documents that would help other people.

Processing Time

• This entire process can be completed within 30 – 40 days or as per the timeline advised by the respective department authority.

Related Videos

Videos explaining the procedure or to fill the applications.
Attach videos using the following tag <&video type='website'>video ID|width|height<&/video&> from external websites.
Please remove the '&' inside the tags during implementation.
Website = allocine, blip, dailymotion, facebook, gametrailers, googlevideo, html5, metacafe, myspace, revver,
sevenload, viddler, vimeo, youku, youtube
width = 560, height = 340, Video ID = Can be obtained from the URL of webpage where the video is displayed.
e.g In the following url 'http://www.youtube.com/watch?v=Y0US7oR_t3M' Video ID is 'Y0US7oR_t3M'.

Instructions

• Applicant must complete the application form before submitting. Incomplete applications will not be accepted.
• Applicant must provide genuine information while applying for this procedure.

Required Information

• Request To Establish Eligibility In
• Medicare/Medicaid Provider Number
• State/County
• State Region
• Identifying Information
• Qualification of Director
• Type of Ownership or Control
• Number of Technologists

Need for the Document

• The form CMS-1880, Request for Certification as a Supplier of Portable X-Ray Services under the Medicare program, is initially completed by the suppliers of portable X-ray services, expressing an interest in and requesting participation in the Medicare program.
• This form initiates the process of obtaining a decision as to whether the conditions of coverage are met as a portable X-ray supplier.
• It also promotes data reduction or introduction to, and retrieval from, the Certification and Survey Provider Enhanced Reporting (CASPER) by the CMS Regional Offices (ROs).

Information which might help

• For more information link

Other uses of the Document/Certificate

Please explain what are other uses of obtaining this document/certificate.
e.g. Birth Certificate can be used as proof of identity.

External Links

Link

Others

More information which might help people.