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 naming Novitas if you are in the East region or Palmetto GBA for the West region. Please click on link to determine your correct Centers for Medicare and Medicaid Service contractor

https://www.palmettogba.com/palmetto/npewest.nsf

Novitas (NPEast)
PO Box 3704, Mechanicsburg, PA 17050

Palmetto GBA (NPWest)
PO 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 $688.

IMPORTANT NOTICE: Professional Malpractice insurance does not meet the requirement for general liability. You must have a separate general liability insurance policy to proceed.

IMPORTANT: Additional information you will need to know.

CMS resumed collecting application fees of $631 and may conducting Fingerprint Criminal Background Checks. A site visit at your office by an inspector is also required.

Please note an additional fee for Revalidation MAY be required every 3-5 years. Failure to respond to the MAC’s request by the revalidation due date, will result in the deactivation of the provider’s or supplier’s Medicare billing privileges. No payments can be made for services provided while Medicare billing privileges are deactivated.

IMPORTANT NOTICE: Once your application has been submitted, you MAY be contacted by The National Supplier Clearing House. It is important that you quickly respond to any request. Failure to respond in a timely manner may delay the enrollment process and may result in the rejection of your application.

In the event that your application is delayed or rejected, you MAY be required to restart the application process which MAY result in additional fees.

If you are ready to begin and you have all the required documents ready to upload, let’s get started.

Easy Peasy. Right?

Sounds easy, right? Hmm, maybe not so much. This process can seem a bit overwhelming, which is why we created this service. If you feel like you need some help before you begin the process, feel free to contact a member of our help me team.