ATLANTA — With the Sept. 30 accreditation deadline coming up fast, HME providers could have some critical paperwork to do, according to accreditation expert Mary Ellen Conway.
"If you are accredited, you may need to communicate this information to the NSC via the 855S form right away," Conway said, adding that even though CMS' accrediting organizations will report accreditation completions to the National Supplier Clearinghouse, providers also must report the change in status through an update to their 855S enrollment form.
"Your accreditor reports your status to Medicare but you must report this as well," said Conway, president of Capital Healthcare Group, Bethesda, Md. "Once you update your information at the NSC, the report from the accreditor is 'matched' to the status report you have made to the NSC via your 855S form."
Conway said she was surprised to learn at a recent conference that many providers who have become accredited this year were unaware they needed to inform the NSC of their accreditation status.
"They were under the impression that the accreditor reported this information and there were no other requirements," she said.
"This could be just another example of the right arm not knowing what the left arm is doing at Medicare, but even so, it's a critical detail you need to be aware of for the survival of your business," Conway warned.
While providers might have reported to the NSC in the past that they are accredited, Conway explained, because accreditation had not been a previous requirement, the NSC has only recently begun to record the information.
"This means that even providers who have been accredited for years and were re-accredited recently may not have their accreditation status on file," she said. "If you have been accredited or even re-accredited anytime in the past three years, you must update your accreditation information via an 855S form immediately.
"If you do not report your accreditation status to the NSC prior to the Sept. 30 deadline, your accreditation status will not be on file and you risk having your provider number terminated on Oct. 1 with your billing privileges revoked."
CMS officials have said that if revocation occurs, there will be a one-year waiting period before a provider can re-enter the Medicare program. (See Get Accredited and Get a Bond or Get Revoked, July 7, for more.)
For providers that aren't going to meet the Sept. 30 deadline, Conway said, voluntary suspension of a billing number means it can be reactivated once accreditation is achieved without having to wait the mandatory one-year period.
Pharmacies that have chosen not to become accredited should change their Part B status to Part B drugs only or risk having billing privileges suspended for a year as well, Conway noted.
She also reminded that as of press time, there had been no exceptions made to the requirement that Part B providers must have a surety bond in place by Oct. 2.
"Right now there are no exceptions," Conway said. "Providers submit their surety bonds to Medicare through the NSC via the 855S form as well."
She advised providers with questions to contact the NSC (toll-free at 866/238-9652) to review their accreditation and bonding information.
"Don't rely on someone else to make sure your billing privileges remain active," Conway said.
For information on DMEPOS accreditation and surety bonds, go to www.cms.hhs.gov/MedicareProviderSupEnroll.