Important!
Here is what you will need before you apply!
Once you begin the application, you will not be able to save and return. If you do not have all of the required information, you will not be able to continue and will be required to start over. Some of this information is ONLY required for Medicare DME
Before you begin, please make sure you have access to ALL of the following:
National Provider Identifier (NPI)
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers. You will be required to provide your NPI-1 and NPI-2 identification number. If you do not know or have not obtained these numbers, your must obtain them before you proceed with your application.
IMPORTANT NOTICE: The Legal Business Name (LBN) and Tax Identification Number (TIN) you use to complete your Medicare application must be the same LBN and TIN you used to obtain your NPI.
Surety Bond
Required for Medicare DME Not Required for Part B)
Durable Medical Equipment providers are required to obtain a $50,000 surety bond prior to Medicare enrollment.
During the application process, you will be required to upload a copy of your surety bond. The Delegated or Authorized Official must sign the bond prior to uploading the document.
If you do not currently have a surety bond in place, you may contact The Keenan Agency for a FREE quote. In most cases, your annual premium will be approximately $250. You may also contact your own insurance agent to find out if they offer surety bonds.
State Dental License
You will be required to upload a copy of your state dental license.
Drug Enforcement Administration License
You will be required to upload a copy of your drug enforcement administration license.
General Liability Insurance
(Required for Medicare DME Not Required for Part B)
You will be required to maintain a general liability insurance policy with a minimum coverage of $300,000. Before you begin the application process, please contact your insurance agent and obtain a Certificate of Insurance naming The National Supplier Clearing House as an additional insured.
National Supplier Clearinghouse MAC
Post Office Box 100142
Columbia, SC 29202-3142
During the application process, you will be required to upload a copy of your general liability insurance Certificate of Insurance with The National Supplier Clearing House as an additional insured.
IMPORTANT NOTICE: Professional Malpractice insurance does not meet the requirement for general liability. You must have a separate general liability insurance policy to proceed.
Medicare Provider Enrollment, Chain and Ownership System (PECOS)
(Required for Medicare DME Not Required for Part B)
You will be required to register for PECOS. You will be required to pay a registration fee of $550.