Medicare

How to Get Credentialed with Novitas Solutions (Jurisdiction H/L) in Pennsylvania

Network: Open
60-90 Days

Quick Overview

Timeline

60 - 90 days

CAQH

Not Required

Re-credentialing

Every 5 year(s)

Delegated

No

Pennsylvania-Specific Requirements

Novitas Solutions (MAC Jurisdiction H/L) processes all Medicare Part A/B claims for Pennsylvania. Enrollment is via PECOS using CMS-855I (individual) or CMS-855B (group). Pennsylvania is one of the largest Medicare markets processed by Novitas, with major provider concentrations in Philadelphia and Pittsburgh. CMS standard screening applies; enhanced screening with fingerprint-based background checks may be required for high-risk categories. A valid NPI is required, and revalidation is every 5 years. Initial enrollment typically takes 60–90 days.

Step-by-Step Enrollment Process

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Pennsylvania.

2

Prepare Your Application

Complete Novitas Solutions (Jurisdiction H/L)'s provider enrollment application with all required information and supporting documentation.

3

Submit Your Application

Submit your completed enrollment package to Novitas Solutions (Jurisdiction H/L).

4

Track & Follow Up

Credentialing typically takes 60-90 days. Monitor your application status and respond promptly to requests for additional information.

Required Documents Checklist

CV/Resume

DEA License

Conditional

Required if applicable

Malpractice Insurance

Medical License

NPI Certificate

Contact Information

Claims Inquiry

National

1-855-609-9960

Medicare Enrollment

National

Medicare Appeals

National

1-855-609-9960

Quick Links

Novitas Solutions (Jurisdiction H/L) Website Provider Portal

Need Help?

Let PayerReady handle your Novitas Solutions (Jurisdiction H/L) enrollment in Pennsylvania.

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Novitas Solutions (Jurisdiction H/L) in Other States

Arkansas Colorado District Of Columbia Delaware Louisiana Maryland Mississippi New Jersey New Mexico Oklahoma

Other Payers in Pennsylvania

Aetna UnitedHealthcare Cigna Healthcare Anthem / Elevance Health Humana Centene Corporation Molina Healthcare Highmark Blue Cross Blue Shield (Western PA) Independence Blue Cross Pennsylvania Medical Assistance
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