How to Become a DMEPOS Supplier for Medicare
Medical practitioners and medical service providing organizations that want to be able to bill the Medicare system for supplying Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) need to undergo a rigorous process.
The procedure is handled by the Center for Medicare and Medicaid Services (CMS). While there are exemptions, it is applicable to medical practitioners who want to act as suppliers of:
- durable medical equipment
- medical supplies
- home dialysis supplies and equipment
- therapeutic shoes
- parenteral/enteral nutrition
- transfusion medicine
- prosthetic devices
- prosthetics and orthotics
Since the beginning of 2019, dentists providing DMEPOS to patients are also required to undergo an accreditation process and meet relevant requirements.
The most important step to becoming a supplier is to obtain DME accreditation. To do that, you have to comply with the supplier standards set for the Medicare program, as well as with the defined quality standards. You also need to provide a $50,000 DMEPOS surety bond as a part of the enrollment after receiving your accreditation.
To help you learn how to become a DME supplier for Medicare, we’ve prepared this step-by-step guide. Learn the basics below.
Obtain a National Provider Identifier number
While this is not a part of the accreditation itself, getting a National Provider Identifier (NPI) number is necessary for meeting the DME license requirements. Existing providers typically have the number already, as it is required by the CMS and commercial healthcare insurers.
If you’re registering now, you’ll need to go through the process with the National Plan and Provider Enumeration System (NPPES). The NPI is a 10-digit number that will be used as your identification in the system for all types of administrative and billing transactions.
Ensure that you meet all supplier and quality standards
Becoming an accredited DMEPOS supplier with the CMS entails satisfying a set of supplier standards. They are detailed in 42 Code of Federal Regulations (CFR) 424.57(c). By adhering with them, you ensure your Medicare billing privileges through the National Supplier Clearinghouse (NSC).
In addition, applicants also have to comply with the set DMEPOS quality standards. They are split into two categories, the first one being business services requirements, which includes administration, finances, HR, consumer service, performance, safety and information. The second one entails product-specific service requirements, which includes intake and assessment, delivery and set-up, training and instruction, and follow-up.
Undergo the DME accreditation process with an approved accreditation organization
The accreditation process is the main answer to the question how to become a DME supplier for Medicare. You have to select one of the 10 approved by the CMS accreditation organizations and get acquainted with their procedure. Then you have to fill in an official application with the respective organization. It will use the Quality Standards to assess your suitability and will make an unannounced on-site survey too.
The accreditation can take up to nine months from the time of your application. Once you have obtained it, you have to undergo the Medicare enrollment with the CMS. Institutional providers have to use CMS-855A Form, while DMEPOS suppliers have to complete CMS-855S Form.
Get your DMEPOS surety bond
One of the main DME accreditation cost is connected with meeting the bonding requirement set in the enrollment process. You have to provide a $50,000 surety bond to the CMS. This amount is necessary for each NPI you have and want to use. Thus, you may need a larger bond amount if you have numerous practice locations as an organizational supplier.
In order to get bonded, you have to pay a bond premium, which is a fraction of the required amount. In case your finances are in good shape, the rates are usually between 1% and 5%. This means that if you have to provide a $50,000 surety bond, your costs would be in the range of $500 to $2,500.
Have more questions about obtaining your DMEPOS surety bond? Don’t hesitate to get in touch with our bonding experts at 877.514.5146.