Enrollment

National Provider Enrollment (NPE)

Looking to become a DME Medicare supplier or are you a DME Medicare supplier who needs to make an update to your enrollment file?

Effective Nov. 7, 2022, two new contractors will process all DMEPOS enrollment applications:

Novitas Solutions NPE East: Alabama, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Mississippi, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, West Virginia, Wisconsin, District of Columbia, Puerto Rico, US Virgin Islands

To find more help on utilizing this new contractor’s website, please visit the "help" tab.

Palmetto GBA NPE West: Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wyoming, American Samoa, Guam, Northern Mariana Islands

These two new contractors are responsible for issuing or revoking Medicare supplier billing privileges for suppliers of DMEPOS. Once the requirements have been met to become a DMEPOS supplier a Provider Transaction Access Number (PTAN) is issued to the supplier for billing privileges. The PTAN is sometimes referred to as the NSC number. Read articles; access learning & educational information; view resources and contact details; and learn about Supplier enrollment related processes, rules, and regulations including supplier standards on the Novitas Solutions NPE East website.

Provider Enrollment Applications

It is best practice to submit applications online through Provider Enrollment, Chain, and Ownership System (PECOS). PECOS is the quickest, most efficient way to submit a Medicare enrollment application.

If you decide to submit paper applications instead, they can be uploaded and submitted using the Provider Enrollment Gateway. This tool can also be used to submit responses to development requests requesting a copy of enrollment correspondence, or to check the status of a previously uploaded application.

Surety Bond

Suppliers seeking to enroll or changing the ownership of a DMEPOS supplier must submit a $50,000 surety bond for each assigned National Provider Identifier (NPI) for which the DMEPOS supplier is seeking to obtain Medicare billing privileges. Please see the surety bond page for more information.

CMS-855S application

The Provider Enrollment, Chain, and Ownership System (PECOS) is the best option to complete and submit your enrollment applications. PECOS supports the Medicare supplier enrollment process by allowing registered users to securely submit and manage Medicare enrollment information online.

What happens to my application upon transition?

If you are within the eastern state region for DMEPOS, your existing enrollment record will be transferred to Novitas in PECOS.

On November 7, 2022 any application still in progress or under review will be transferred from the NSC to Novitas Solutions and will receive a new document control number (DCN). A Novitas representative will communicate your new DCN by calling or emailing the contact person listed on the application. There is no action required from you!

Appeals & Rebuttals

Suppliers may send enrollment appeals and rebuttals to Chags Health Information Technology LLC (C-HIT):

Mailing Address:

C-HIT
P.O. BOX 45266
Jacksonville, FL 32232

Fax: (866) 410-7404

Phone: (800) 245-9206

E-mail: PEARC@c-hit.com

Participating vs non-Participating

Electronic Funds Transfer (EFT)

CMS-588 Electronic Funds Transfer (EFT) Authorization Agreements must be sent to the applicable National Provider Enrollment (NPE) contractor for the supplier’s physical location.

Bank information must be applicable for all four jurisdictions. The Part III Financial Institution Information listed on the EFT agreement must be the same for all jurisdictions, regardless of the supplier’s physical address.

CMS-588 forms received by the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) between August 21, 2023, through November 19, 2023, will be forwarded to the correct NPE contractor. EFT forms received by the DME MAC on or after November 20, 2023, will be rejected and returned to the supplier.

EFT Inquiries

Suppliers must contact the appropriate NPE contractor for all inquiries related to electronic funds transfers. This includes questions about all other EFT correspondence sent to suppliers by the DME MACs or the NPE contractors, status of EFT requests, and changes in EFT information.

This is supported by 42 Code of Federal Regulations (CFR) § 424.510 - Requirements for enrolling in the Medicare program:

(e) Providers and suppliers must -

(1) Agree to receive Medicare payment via electronic funds transfer (EFT) at the time of enrollment, revalidation, change of Medicare contractors where the provider or supplier was already receiving payments via EFT or submission of an enrollment change request. and

(2) Submit the CMS-588 form to receive Medicare payment via electronic funds transfer.

The enrollment contractors will notify you when you must transition from paper checks to EFT.

 

Last Updated Oct 05 , 2023