How to Become a Medicare Medical Equipment Vendor

Medical equipment supplies are a covered Medicare benefit when medically necessary for a patient. For a vendor or supplier to bill and receive payment from Medicare, it must enroll as a Medicare Durable Medical Equipment and Prosthetic and Orthotic Device Supplies (DMEPOS) supplier.

Medical equipment suppliers considering enrolling in the Medicare program should familiarize staff with Medicare standards for suppliers, including quality standards, and ensure that all steps toward becoming a Medicare vendor are completed thoroughly and accurately. Timely responses to information requests and questions during the application review process will minimize costly delays in gaining approval.

Things You'll Need

• DMEPOS Medicare Enrollment Application (Form CMS-855S)
• National Provider Identification Number (NPI)
• Comprehensive liability insurance policy in amount of $300,000 or more with National Supplier Clearinghouse as policy holder
• Surety bond of $50,000 for each location (unless exception applies)
• Electronic Funds Transfer Authorization Agreement (Form CMS-588)

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Instructions

Pre-enrollment Preparation

• 1

  Download and print the enrollment application (Form 855S) at http://www.cms.hhs.gov/cmsforms/downloads/cms855s.pdf.
  Carefully read the form, including penalties for submitting false or incomplete information, surety bond requirements and exceptions, supplier standards, and privacy information.

• 2

  Arrange for an accreditation survey to demonstrate compliance with Medicare supplier and quality standards. The standards can be found at http://www.cms.hhs.gov/MedicareProviderSupEnroll/Downloads/DMEPOSAccreditationStandards.pdf.

  Medicare's list of approved supplier accreditation organizations is available at http://www.cms.hhs.gov/MedicareProviderSupEnroll/Downloads/DeemedAccreditationOrganizations.pdf.

• 3

  Gather and make copies of all required licenses, certifications and accreditations. For state-by-state information on requirements, consult the DMEPOS State License Directory at http://www.palmettogba.com/palmetto/statelicensure.nsf.

• 4

  Obtain liability insurance of at least $300,000 and surety bonds of $50,000 for each location. These are required for Medicare supplier enrollment.

• 5

  Obtain a National Provider Identification Number. This can be done online at https://nppes.cms.hhs.gov/NPPES/StaticForward.do?forward=static.instructions, by calling [phone], or by submitting the NPI application to NPI Enumerator, P.O. Box 6059, Fargo, ND 58108-6059.

• 6

  Obtain written confirmation from the IRS of your Employer Identification Number (EIN) and legal business name.

• 7

  Decide whether to "participate" in Medicare---i.e., whether you'll accept payment directly from Medicare. This customer convenience may provide a significant business advantage. To participate in Medicare, complete Form CMS-460 and retain a copy to submit with the enrollment application.

Application Process

• 8

  Complete the enrollment application (CMS-855S) online or by manually typing/printing the information on the form. Do not use pencil.

• 9

  Obtain signatures from (and provide Social Security numbers for) the authorized official and any delegated officials. Providing delegated official information is optional, but only authorized and delegated officials can make changes to information supplied on the enrollment form.

• 10

  Gather and make a record copy (or copies) of the completed and signed CMS-855S and all supporting documentation gathered in Section 1.
  Mail the information to National Supplier Clearinghouse at:
  P.O. Box 100142
  Columbia, SC 29202-3142
  or send overnight to:
  Palmetto GBA AG-495
  2300 Springdale Drive, Bldg. 1
  Camden, SC 29020

• 11

  The NSC will review the application and supporting documentation. Respond quickly to any questions or requests for additional information to avoid processing delays.

• 12

  The NSC will schedule and conduct a site visit to ensure compliance with the supplier standards. This is in addition to, and independent of, the accreditation survey and certification. After completing the application review and site visit, NSC will provide written notification of its decision.