MEDICARE ENROLLMENT APPLICATION - CMS

MEDICARE ENROLLMENT APPLICATION . Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers CMS-855S. SEE PAGE 1 FOR A LIST OF THE DMEPOS SUPPLIER STANDARDS. TO ENROLL IN THE MEDICARE . PROGRAM AND BE ELIGIBLE TO SUBMIT CLAIMS AND RECEIVE PAYMENTS, EVERY DMEPOS SUPPLIER. APPLICANT MUST MEET AND MAINTAIN THESE ENROLLMENT STANDARDS. SEE PAGE 2 TO DETERMINE IF YOU ARE COMPLETING THE CORRECT APPLICATION . SEE PAGE 4 FOR INFORMATION ON WHERE TO MAIL THIS APPLICATION . SEE SECTION 12 FOR A LIST OF SUPPORTING DOCUMENTATION TO BE SUBMITTED WITH THIS. APPLICATION . TO VIEW YOUR CURRENT MEDICARE ENROLLMENT RECORD GO TO: Form Approved DEPARTMENT OF HEALTH AND HUMAN SERVICES OMB No. 0938-1056. CENTERS FOR MEDICARE & MEDICAID SERVICES Expires: 05/19. DMEPOS SUPPLIER STANDARDS FOR MEDICARE ENROLLMENT .

accreditation organization in order to receive and retain a supplier billing number. The accreditation must indicate the specific products and services for which the supplier is accredited in order for the supplier to receive payment for those specific products and services (unless an exception applies). 23.

Loading..

Tags:

  Applications, Enrollment, Accreditation, Enrollment application

Information

Related search queries