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Medicare: Types of Roles

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Role types and how to use them

First, let's look at the role types.

Authorized Official means an appointed official such as the chief executive officer, chief financial officer, general partner, chairman of the board, or direct owner. This person has the legal authority to enroll the organization in the Medicare program, make changes/updates, and ensure the organization will fully abide by the statutes, regulations, and program instructions of the Medicare program. This typically will be the owner. If there are multiple owners, they can choose amongst themselves who will be the one to sign on behalf of the group.

Delegated Official means an individual delegated by the “Authorized Official.” They have the authority to report changes and updates to the enrollment record. The delegated official must also be an individual with an ownership or control interest in or be a W-2 managing employee of the provider or supplier.

Access Manager (AM) was previously named Delegated Official (DO) and was changed on June 8th, 2020.  This was only a title change, and no role functionality has been modified. AMs have access to all business functions for the employer organizations for which they have been approved. AMs are authorized to manage all Staff End Users for the employer organizations. They can also manage connections between the employer organizations and other entities. Examples for this role would be an office manager, another owner, investor.

Staff End (SEU) is a role of the I&A system that is invited to work as staff for the organization by its Authorized Official (AO) or Access Manager (AM). The AO or AM manages the user’s access so that the organization can be permitted to work on behalf of providers with approved surrogate connections. The Staff End Users for an employer may view their employer information and view connections for their employer in I&A. Staff End Users may be granted access to PECOS.

SEUs do not automatically have access to all business functions; they must be provided access by their AO or AM. This role would be for people outside your office such as a credentialing specialist, consultant, or auditor.

How to use the roles

Authorized Official

Once you've made your NPI on the NPPES site, you'll have access to two other sites, I&A, and PECOS. Read the article "PECOS has Three Sites?" for more information on each site and how to use them.

PECOS is where you will submit your Medicare application(s). As an individual, you are in charge of your NPI (type 1), so you can go straight to PECOS and start your individual application. If you've made your group NPI (type 2), you'll need to show that you are legally in charge of the group's NPI and allowed to submit applications on behalf of the group.

To do this follow these steps.

1. Go to the I&A site.

2. On the "My Profile" tab, under the "Employer Information," click the “+” sign next to your group's name.

3. Select the “Request Role Change” button. The Request Role Change screen will allow you to change your role to "Authorized Official".

4. Upload your group's IRS letter to complete this request.

Access Manager/Delegated Official

You need to perform a role change request on the My Profile page under the employer information section at the bottom of the page, and have your Authorized Official approve you to be an Access Manager, or submit the appropriate IRS documentation to EUS. The “Request Role Change” button can be access when you expand your employer information by selecting the “+” sign next to your employer.

Step 1: Login to I&A and click on My Profile Tab. Scroll to bottom of page and click the + sign next to the employer name. Scroll down and click on the button that says Request Role Change

Step 2: select the role you want to request for your employer.

Step 3: If you are requesting to be an AM, you will be asked for additional information for your organization’s Authorized Official (AO). Note this individual may or may not already be in the system.

Step 4: You will receive an e-mail advising you that the request has been submitted.

Step 5: To obtain Access Manager role approval, you have two options:

1) Print and sign an Access Manager Certificate form and mail to EUS per the instructions on the form. On receipt of the AM Certificate form, EUS will process for approval. Note that a CP 575 or other IRS document must also be sent to EUS with the Access Manager Certification.

2) If the Authorized Official listed above or any other Authorized Official for your employer has an established User ID in the system, the Authorized Official can login and immediately approve your request

Staff End

Authorized Officials and Access Managers for employers may add staff for their employer(s). On the My Staff/Add Staff page, enter the name and e-mail address of the staff user, and select the employer(s) and role(s) you wish to add. Important: The staff user will receive an invitation to work for the employer(s) and can register (if a new user) or login (if an existing user) to be added to the designated employer(s). Staff End Users cannot add themselves to employers and must be invited. Access Managers may add themselves to employers or be invited.

To remove a person from a role

To remove an employee from your employer staff, as an Authorized Official (AO) or Access Manager (AM) for your employer, you should find the user’s name on the My Staff page and select the “Modify” button, uncheck the box for that staff member for the selected employer, and then confirm the removal of that staff member.

This will remove the staff user's access to the employer. In addition to removing access to the employer, the staff user's access to providers the employer is a surrogate for is also removed. The system will set the staff user’s status to “Disassociated” for the employer. If the staff user is not an employee for any other employers for which you are also an AO or AM, that staff user will then show up in the Inactive Staff table on the My Staff page when you return to the My Staff page.

Note that Authorized Officials may remove access to an employer for Access Managers and Staff End Users for that employer. Access Managers may remove access to an employer for Staff End Users for that employer.

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