DME Supplier Revalidation Notice

Your DME supplier revalidation letter is coming, are you ready?  Here is what you need to do for revalidation.

In accordance with the Patient Protection and Affordable Care Act (PPACA), all new and existing suppliers of Durable Medical Equipment Prosthetics, Orthotics, and Suppliers (DMEPOS) must be reevaluated under the new screening guidelines.  CMS requires DMEPOS suppliers to revalidate enrollment information with the National Supplier Clearinghouse (NSC) every three years.  Once you receive your revalidation letter from CMS, you have 60 days from the date of the letter to submit your complete enrollment.  You cannot initiate your revalidation you must wait for your letter from CMS.

Process includes:

  •          Completing the CMS 855-S application (paper application or online at www.cms.hhs.gov) through the internet based Provider Enrollment, Chain and Ownership System (PECOS).
  •          You must submit certification documents and other supporting documents (see page 35 0f the 855-S application) by mail and must be submitted within 7 days of completing the online enrollment application. 
  •         All suppliers are required to submit enrollment fee (2012 fee is $523) via Pay.Gov prior to submitting the application.

Failure to submit a timely revalidation will result in deactivation of your billing privileges.  Should this occur, it may take up to three years to reactivate.  In addition, make sure you keep your DME Supplier status current. 

Are your providers in PECOS?

Check to see that your internal and external doctors who write prescriptions are registered in PECOS.  These providers must appear in the CMS “Ordering Referring Report” or the dispensary will not get paid. 

Are your NPI and PTAN records compliant?

Confirm that your optical’s NPI information is up-to-date and matches the information you file in the CMS 855-S application.  To search the NPI directory go to www.nppes.cms.hhs.gov. Each of your optical locations that you are revalidating as current DME Suppliers must have their own individual NPI and DME PTAN numbers which must be linked together in their NPI registry record.

For any questions or additional information, please contact Ann Deen at cadeen@tso.com.

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