From the Desk of Ronda: Want to Avoid Supplier Number Issues? Read On!

Published in Government Relations on May 16, 2022

Maintaining a supplier number is vital to the supplier’s business. There is an update and a few reminders that need to be shared with the VGM membership that will assist with sustaining smooth operations.

In January 2022, CMS released an MLN article (MLN 905710) with an update related to accreditation requirements and services being offered a DMEPOS company.

The update states the following, "CMS will deny your claims if you aren’t accredited by a CMS approved accreditation organization. Starting January 3rd, 2022, we’ll tell you on your remittance advice if you aren’t properly accredited."

What this means is that you, as the DMEPOS supplier, need to review the products and services your business furnishes within PECOS (or on the 855S application pages 11-13), making sure it matches the information on file with your accreditation organization. If these do not match, it will cause issues with getting claims paid and possibly cause deactivation of your PTAN. The Supplier Standard to reference is standard 25.

With both the accreditation organizations reviewing certifications and performing site surveys and the revalidations with the National Supplier Clearinghouse (NSC), this is the time to review both sets of information to make sure they match, in addition to asking your billing team if they have received any of these denials.

Secondly, a reminder regarding Surety Bonds, supplier standard 26. A DMEPOS supplier must maintain a valid bond that is no less than $50,000. You need to make sure the bond is maintained at $50,000, and you need to make sure it’s renewed annually. When it’s renewed, this needs to be shared with the NSC. Any issues with a surety bond is a risk for PTAN issues, including potential deactivation.

Finally, make sure the correspondence address and contact information are correct in PECOS (or 855s). Any changes to your business that is relevant to following the supplier standards and maintaining billing privileges must be communicated to the NSC within 30 days of the change (pre or post-change). This falls under supplier standard 2.

Please reach out to me with any further questions regarding your supplier number. Also, let me know if you are experiencing any of these issues.

Supplier Standards DMEPOS Basic Fact Sheet

Ronda Buhrmester
Sr. Director of Payer Relations and Reimbursement
ronda.buhrmester@vgm.com
217-493-5440


TAGS

  1. billing & reimbursement
  2. dmepos
  3. reimbursement
  4. vgm
  5. vgm government

From Our Experts

CMS Rule Phases Out Fax Machines, Snail Mail to Save Taxpayers $781.98 Million a Year thumbnail CMS Rule Phases Out Fax Machines, Snail Mail to Save Taxpayers $781.98 Million a Year As reported by CMS: “The Centers for Medicare & Medicaid Services (CMS) is slashing wasteful spending and antiquated paperwork by swapping out faxing and mailing for streamlined electronic transactions. This action lets providers spend less time on administrative hassle and more time caring for patients. PAMES Raises Critical Concerns Over Sole-Source Supply Shift thumbnail PAMES Raises Critical Concerns Over Sole-Source Supply Shift PAMES and DME suppliers across Washington are taking an important stand on behalf of both providers and patients. The Tacoma Daily Index recently reported on the state's plan to move to a sole-source contract for incontinence and urological supplies. Under this decision, the Health Care Authority intends to transition all Medicaid recipients to receiving these products from a single vendor. SBA Advocacy: Your Input Matters thumbnail SBA Advocacy: Your Input Matters Make your voice heard about how the CBP has affected your business. New Bipartisan Senate Bill Aims to Improve Access to Diabetes Technology & Education for Medicare Beneficiaries thumbnail New Bipartisan Senate Bill Aims to Improve Access to Diabetes Technology & Education for Medicare Beneficiaries U.S. Senators Jeanne Shaheen (D-NH) and Susan Collins (R-ME), Cochairs of the Senate Diabetes Caucus, have introduced the Diabetes Interventions Addressing Barriers to Enrollment, Technology, and Education Services (DIABETES) Act, S.4037. VGM Reintroduces the Fraud, Waste & Abuse Reporting Resource Center thumbnail VGM Reintroduces the Fraud, Waste & Abuse Reporting Resource Center VGM Government Relations is proud to announce the reintroduction of its Fraud, Waste & Abuse (FWA) Reporting Resource Center—a newly refreshed online hub designed to protect the integrity of the DMEPOS industry and reinforce our unwavering commitment to ethical, compliant care. Celebrating Another DME Champion of Change: Thom Harvill of Above and Beyond Medical thumbnail Celebrating Another DME Champion of Change: Thom Harvill of Above and Beyond Medical We're proud to once again recognize a true Champion of Change in the DME industry: Thom Harvill of Above and Beyond Medical in Tennessee. Thom has dedicated many years to the DME community—consistently showing up, speaking out, and pushing the industry forward. He's the kind of advocate who never stops asking, “Who else can I reach out to about this?” Federal Actions This Week Signal The Administration Is Doubling Down On Its Goal To Eliminate Fraud Waste And Abuse thumbnail Federal Actions This Week Signal The Administration Is Doubling Down On Its Goal To Eliminate Fraud Waste And Abuse This week, the Trump administration, through the Centers for Medicare & Medicaid Services (CMS), announced a significant deferral of federal Medicaid matching funds to Minnesota alongside the release of a new Request for Information (RFI) tied to the administration's Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) initiative. These actions along with the changes to DMEPOS accreditation and enrollment signal the administration's aggressive posture on Medicaid and Medicare... VGM Response To CMS Moratorium On New DMEPOS Provider thumbnail VGM Response To CMS Moratorium On New DMEPOS Provider The federal moratorium on new DME suppliers presents a defining moment for us as an industry—an opportunity to demonstrate that the VGM members serving patients are the gold standard. We have long shown that our members operate with integrity, excellence in compliance, and unmatched commitment to service, efficiency, and patient outcomes. Now, we must elevate that message.