Medicare DME Credentialing
We assist from start to finish with Medicare DME credentialing.
In order to start the process, please collect the following items:
DME Credentialing Information
I will need the following items BEFORE we start the application process.
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1. A copy of IRS EIN form. * See example attached
2. A copy of physician’s state license
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3. A certificate of insurance (COI) with National Supplier Clearinghouse as additional insured. This is your “slip & fall” insurance. Your insurance carrier will do this when you call with the address below. *See example attached
If your clinic is located east of the Mississippi River in these states:
AL, CT, DE, FL, GA, IL, IN, KY, ME, MD, MA, MI, NH, NJ, NY, NC, OH, PA, RI, SC, TN, VT, VA, WV, WI, Wash DC, PR, US Virgin Islands
Novitas Solutions, Inc
P.O. Box 3704
Mechanicsburg, PA 17055-1863
If your clinic is located west of the Mississippi River use this address as your COI
Palmetto GBA, AG-495
P.O. Box 100142
Columbia, SC 29202-3142
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4. A copy of a voided check for new DME company.
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This check must be from a financial institution that has no financial interest in your practice.
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(No loans, credit cards or any debt owed to this bank)
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The account must be separate and only for new DME.
5. NPI number for organization.
6. NPI number for individual.
7. Need a managing member’s information. (This may be given during the conference call.)
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Date of birth
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Place of birth
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Social Security number
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Once we have all the copies of the above items, you can schedule a DME consult call. The doctor MUST be on this call to go over the process.
![COI example wAddress.jpg](https://static.wixstatic.com/media/09c744_f1faba77aec945aeb67edd010a9d7065~mv2.jpg/v1/fill/w_600,h_776,al_c,q_85,usm_0.66_1.00_0.01,enc_auto/COI%20example%20wAddress.jpg)
![EIN-Confirmation-Letter.jpg](https://static.wixstatic.com/media/09c744_1acf0f9c5d584083a2b80f2813546d54~mv2.jpg/v1/fill/w_600,h_776,al_c,q_85,usm_0.66_1.00_0.01,enc_auto/EIN-Confirmation-Letter.jpg)