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

[BREAKING NEWS] The DMEPOS Relief Act of 2023 is Introduced in the House thumbnail [BREAKING NEWS] The DMEPOS Relief Act of 2023 is Introduced in the House Reps. Miller-Meeks (R-IA) and Tonko (D-NY) introduced the DMEPOS Relief Act of 2023, H.R. 5555. Jeremy Stolz and Industry Leaders Collaborate with Representative Cathy McMorris-Rodgers to Enhance Healthcare System thumbnail Jeremy Stolz and Industry Leaders Collaborate with Representative Cathy McMorris-Rodgers to Enhance Healthcare System Jeremy Stolz, President of VGM & Associates and VGM Fulfillment, joined forces with fellow industry leaders in a momentous meeting with Representative Cathy McMorris-Rodgers (R-WA) on Aug. 17, 2023, in Sun Valley, ID. Uncovering Denials: OIG Reports Reveal Alarming Trends in Medicaid Managed Care Plans thumbnail Uncovering Denials: OIG Reports Reveal Alarming Trends in Medicaid Managed Care Plans In 2022, the OIG released a report outlining their findings which concluded that Medicare Advantage plans were routinely denying authorizations requests and claims for items that would be covered by traditional Medicare Fee For Service (FFS). Understanding the 75/25 Blended Rate and Why We Need Legislative Action! thumbnail Understanding the 75/25 Blended Rate and Why We Need Legislative Action! In 2020, amidst the challenges posed by the COVID-19 pandemic, the healthcare industry witnessed the introduction of the 75/25 blended rate through the passage of the CARES Act. Craig Douglas and Ronda Buhrmester recently released a podcast going into a deep explanation of the 75/25 blended rate and why keeping them in place is so important. Read the article and listen to the podcast to learn more! Ronda Vlog: Make it a Priority - A Plea to Check Surety Bonds thumbnail Ronda Vlog: Make it a Priority - A Plea to Check Surety Bonds Listen below, Ronda Buhrmester, Sr. Director of Payer Relations and Reimbursement, makes a plea for everyone to check their surety bonds before it is too late. August of Action: Making an Impact on Legislation thumbnail August of Action: Making an Impact on Legislation With summer coming to an end, the political landscape is heating up with August of Action in full swing. Advocates and activists across the nation are seizing the opportunity to engage with their legislators as they are home in their congressional districts. Find out how VGM Government Relations is kicking off our August of Action! August of Action is Fast Approaching - Act Now! thumbnail August of Action is Fast Approaching - Act Now! Every year, the House of Representatives and the Senate take a break for most of August and the first part of September, allowing elected officials to return to their home constituencies. It's a crucial time to connect with your legislators and schedule meetings to inform and update them on the current issues in the home medical equipment (HME) industry. A Win for Patients in Washington State thumbnail A Win for Patients in Washington State As we approach the effective date of numerous laws passed by the Legislature this year, we want to extend our appreciation to Don Whitney, PAMES, and all those involved in the relentless efforts to get SB 5218 passed. With the dedicated sponsorship of 4th District Sen. Mike Padden, this law marks a significant step forward in making motorized wheelchairs more accessible for everyone.