CMSFORM.ORG – CMS 855S – Medicare Enrollment Application – Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers – As a Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) supplier, enrolling in Medicare can be crucial for your business’s success. One of the key steps is completing the CMS 855S enrollment application. This application process ensures that you are eligible to provide DMEPOS items and services to Medicare beneficiaries.
The CMS 855S application is designed specifically for suppliers who offer these types of medical equipment and supplies. It includes important information about your business operations, such as ownership structure and location details. Completing this application is essential for DMEPOS suppliers who want to participate in Medicare programs like competitive bidding or fee-for-service reimbursement.
Download CMS 855S – Medicare Enrollment Application – Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers
| Form Number | CMS 855S |
| Form Title | Medicare Enrollment Application – Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers |
| Published | 2022-01-01 |
| O.M.B. | 0938-1056 |
| File Size | 1 MB |
What is a CMS 855S?
The CMS 855S is a Medicare enrollment application for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers. The purpose of this form is to collect information from suppliers who wish to enroll in the Medicare program as a supplier of DMEPOS items and services. This form is required by the Centers for Medicare & Medicaid Services (CMS) before any supplier can begin billing Medicare for their services.
The CMS 855S application consists of several sections that require various types of information including general business information, ownership details, organizational structure, and specific details about the DMEPOS items and services being offered. Additionally, there are various supporting documents that must be submitted with the application such as proof of state licensure and accreditation certificates.
Overall, the CMS 855S enrollment process can be quite complex and time-consuming due to the detailed nature of the application. However, it is essential for any supplier looking to provide DMEPOS services to Medicare beneficiaries as failure to complete this process correctly can result in denied claims or even legal consequences.
Where Can I Find a CMS 855S?
The Centers for Medicare & Medicaid Services (CMS) requires suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) to enroll in the Medicare program by completing and submitting a CMS-855S application. This application provides necessary information about the supplier’s business structure, ownership, location(s), payment processing methods, and other details related to their eligibility for Medicare reimbursement.
To find a CMS 855S application form, visit the official CMS website or contact your regional DME MAC contractor directly. Additionally, some third-party vendors may offer assistance with filling out and submitting this application on your behalf for a fee. However, it is important to note that only authorized individuals may complete and sign an enrollment application. Therefore, ensure that all required signatures are obtained before submission to avoid any delays or rejections of your application.
Once you have submitted your completed CMS-855S form along with all required supporting documents, you should receive confirmation from CMS within 90 days regarding your enrollment status. If approved for participation in the Medicare program as a DMEPOS supplier, be sure to maintain accurate records and comply with all applicable rules and regulations to continue receiving reimbursements from Medicare.
CMS 855S – Medicare Enrollment Application – Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers
The CMS 855S Medicare Enrollment Application is a form that must be completed by Durable Medical Equipment (DME), Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers who wish to enroll in the Medicare program. The application is necessary to become an approved supplier of medical equipment and supplies for Medicare beneficiaries.
The CMS 855S application includes questions regarding the supplier’s ownership and organizational structure, business operations, accreditation status, financial information, compliance with federal healthcare program requirements and other details. The information provided in the application is used by Medicare to determine if a supplier meets the eligibility criteria for participation in the program.
It is important for DMEPOS suppliers to complete their CMS 855S enrollment application accurately and thoroughly as incomplete or incorrect information can result in delays or denial of participation in the Medicare program. Once enrolled, suppliers must maintain their enrollment status by submitting periodic updates and reporting any changes in their business operations or ownership structure.
CMS 855S – Example
