If you are a medical supplier that wants to bill the Medicare system for your sales of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), there are several qualifications that you must meet.
These DMEPOS supplier requirements are put in place by the Centers for Medicare & Medicaid Services (CMS) to ensure that supplies meet their quality standards.
In this post, we will outline the various requirements and explain how you can become a DME supplier.
What is a DME supplier?
Durable Medical Equipment (DME) is a type of medical equipment ordered by healthcare providers, primarily physicians. A DME supplier is a business that sells this type of medical equipment. Some examples of DME equipment include:
- Prosthetics and orthotics
- Medical supplies
- Home dialysis supplies and equipment
- Therapeutic footwear
- Parenteral nutrition
- Transfusion medicine
- Durable medical equipment
While there are a few exceptions, any supplier that wants the ability to bill the Medicare system for these types of supplies must follow the CMS accreditation process.
The process is simple but time-intensive. Below are five steps you can take to become a DMEPOS supplier:
Step 1. Get a National Provider Identification Number
The first step to becoming a DME supplier is to get a National Provider Identification (NPI) number. The NPI is a 10-digit number that is used to identify your business in the CMS’s records.
You can obtain your NPI from the National Plan and Provider Enumeration System (NPPES).
Step 2. Learn the CMS quality standards
The next step is to verify that your business is in compliance with all CMS standards for DME suppliers. The rules are divided into two categories:
The first covers business services requirements such as finances, HR, administration, and performance.
The second covers product-specific service requirements including training and instruction, delivery, intake and assessment, and follow-up.
These are just some of the topics covered in the DMEPOS Quality Standards. You’ll want to take a look at 42 Code of Federal Regulations (CFR) 424.57 to ensure you are aware of all the requirements.
By doing so, your business will remain in compliance with the CMS and be able to bill Medicare for your supplies.
Step 3. Apply for accreditation
Now, you will need to apply for CMS accreditation through one of 10 approved accreditation organizations.
Review the list of organizations and choose one with whom to complete the accreditation process. The exact process will vary depending on the organization.
But, no matter who you use, be prepared to fill out an application, submit a bunch of documents, and have the organization review your adherence to the CMS standards.
After you submit your application, it can take the accreditation organization four to six months to review.
Step 4. Pass the survey conducted at your place of operation
After the organization reviews your application, they will visit your place of business unannounced to conduct a survey. During this visit, a surveyor from the National Association of Boards of Pharmacy will review the business location to ensure that the supplier meets all the required standards.
If you meet all the standards, the accreditation organization will report your new accreditation to the National Supplier Clearinghouse (NSC).
Once you are accredited, you can complete Medicare enrollment with the CMS. To do so, you will need to submit form CMS-855S. If you are an institutional provider, you will need to complete form CMS-855A.
You can use the CMS PECOS system to submit your Medicare application.
Step 5. Get a DMEPOS surety bond
The final step to becoming a fully active DME provider is to get a surety bond. The bond acts as an assurance that the supplier will not commit Medicaid fraud. In the event that they do, damaged parties can file a claim against the bond seeking financial compensation.
The CMS requires you to get a DMEPOS bond worth $50,000 for each of your business locations. This is the amount of your coverage and is the maximum amount the surety could payout for a successful claim.
Your business will need to pay part of this total amount as a premium. When the surety issues your bond, they will evaluate your business and determine your premium.
EZ Surety can issue DMEPOS bonds for as low as $500.
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