DME MAC JURISDICTION C - CGS

Supplier Enrollment Chapter 2Overnight Mail AddressNational Supplier ClearinghouseAG-4952300 Springdale Dr., Bldg 1Camden, SC 29020Participating/NonparticipatingA Medicare participating supplier is one who voluntarily enters into an agreement to acceptassignment for all services furnished to Medicare beneficiaries during a 12-month period, beginningJanuary 1 of each year. Suppliers who choose not to sign the participation contract are referred to asnonparticipating suppliers. Nonparticipating suppliers may choose to accept assignment on a claimby-claimbasis except where CMS regulations require mandatory assignment (i.e., Medicare covereddrugs, home dialysis equipment and supplies, Indian Health Services). Accepting assignment meansaccepting the Medicare approved amount as payment in full. Participation status is part of theenrollment process through the National Supplier Clearinghouse.Open enrollment forms (CMS-460, Medicare Participating DMEPOS Supplier Agreement) are mailedto all suppliers every November. If an existing nonparticipating supplier wants to becomeparticipating, then the agreement form must be received during open enrollment and postmarkedbefore December 31st of that year.If a participating supplier wants to become nonparticipating, they can request to becomenonparticipating by sending the request to the NSC on their company letterhead. The request mustbe postmarked and received before December 31st of that year to become nonparticipating effectiveJanuary 1st of the next year.New legislation each year provides incentives for suppliers to participate. These incentives areoutlined in the participation enrollment letter sent to all suppliers each year, along with other valuableinformation.Site VisitsSite Visits:• Are a tool used by the NSC to assist in making a determination as to whether or not asupplier is in compliance with the twenty-one supplier standards• Are conducted in all fifty states and territories• Are completed for initial applications, reenrollments and reactivations• Can and will be conducted at anytime if deemed necessaryThe site visit along with the application and supporting documentation are considered in making adetermination to issue, deny or revoke a supplier’s billing privileges. Refer to the NSC Web site foradditional information regarding site visits.DME MAC Jurisdiction C Supplier Manual Page 6