Medicare is an insurance program, offered by the federal social committee and popular among DME billing companies and customers as well. It focuses primarily on older and disabled people. Medicare holds a share of 21% in terms of U.S healthcare expenses and 17.8% of Americans based out of the U.S have been covered by Medicare. Therefore, most of the DME billing companies first prefer enrolling in insurance programs offered by Medicare.
If you are a new DMEPOS supplier, you should definitely register your business with the Medicare enrollment application to become qualified to get paid for insured customers through Medicare. This blog takes you through the complete Medicare procedures for DME billing and how it is effective as well.
The application form provided by Medicare requires you to fill in all the information about you and secures only the needed documentation. This cross check’s your eligibility criteria before you apply for DMEPOS with Medicare and then allows you to enroll in the program.
How to enroll in Medicare?
The Medicare enrollment process is very simple and quick as well.
- First, the National Supplier Clearinghouse (NSC) initiates and progresses your enrollment application and proceeds with the verification of your information.
- In case NSC asks for more information in the due course, you should be in a position to provide the same.
- You should respond to the mail requests sent by NSC immediately; showing a delay in response can lead to further delay in your enrollment.
The following procedure is for becoming a DMEPOS (Durable medical equipment, Prosthetic, Orthotics, and Supplies) supplier.
Step 1: The applicant fills and submits the Medicare enrollment application form and the respective documents to the NSC.
Step 2: The NSC validates the application and carries out a site visit to ensure and mark compliance with all DMEPOS supplier standards.
Step 3: Once the verification is complete, the NSC informs the applicant through mails about the status of their decision towards the applicant’s enrollment application.
If you have any information to be changed in the Medicare enrollment application form, you should inform the NSC within 30 days of applying. You do not have to grab a new enrollment form; instead, you can make use of your existing application form and mention, highlight the changes alone.
Before we get close to the final step in the Medicare program enrollment procedure, you must know about the term Participation. Participation is more or less similar to accepting assignment of claims every time for all services you offer to beneficiaries of Medicare. It also ensures that you collect payments as one-time and do not claim other than Medicare deductible or coinsurance of the beneficiary if any. Though you agree to the point of participation or not, according to the Social Security Act, Medicare expects you to submit claims for its beneficiaries without fail.
The participation benefits you in several ways. As a DMEPOS supplier, you receive the payments directly from Medicare because they are all assigned. The claim information is transferred to Mediated insurers i.e. for medical supplemental coverage.
Medicare enrollment and registration
The standard healthcare transactions in recent times are controlled by the National Provider Identifier (NPI) over the healthcare provider identifiers. So it becomes an unleveraged rule for DMEPOS suppliers to acquire the NPI before they intend to enroll in Medicare programs. Only if you do this, you will be able to bill and be paid for services offered to Medicare beneficiaries.
24/7 Medical Billing Services is one such company that tops when it comes to DME billing and coding, helping independent doctors, nursing homes, hospitals across the United States, by handling their medical billing effortlessly and efficiently. The best part with 24/7 is they are experts in Credentialing, A/R Follow up and denial management services across the nation.