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Linda Collins Blogger

The Medicare Supplier Manual

Posted by Linda Collins | November 17, 2015

In addition to LCDs, Policy Articles, and other articles published by the MACs, the supplier manual is available to assist suppliers with information on supplier enrollment, claims submission, ABNs, documentation, and coding.

CMS selected four insurance companies to process DMEPOS claims for the Medicare Fee-for-Service program. These companies function as Durable Medical Equipment Medicare Administrative Contractors (DME MACs). The DME MACs are divided into four geographical jurisdictions (A-D). Each jurisdictional contractor is responsible for handling DMEPOS claims for beneficiaries residing in their jurisdiction. Each contractor is also responsible for providing the DMEPOS Supplier Manual to suppliers in their geography. The content of the Supplier Manual is the same across all four regions, but the chapter numbering and format may change.

​Chapters of importance include "Supplier Documentation", "DMEPOS Fee Schedule Categories", and "Inquiries, Reopenings and Appeals."

The Supplier Documentation chapter covers information about who is able to write a prescription, the documentation needed in the patient's medical record, and signature requirements. This chapter also details the requirements of an ABN and Proof of Delivery form.

Information regarding repairs, replacements and billing for custom items that are not delivered, can be found in the chapter entitled "DMEPOS Fee Schedule Categories." Another chapter, "Inquiries, Reopenings and Appeals", provides details regarding audits and appeal opportunities.

What does this mean to you?

You and your staff need to be familiar with the Supplier Manual and reference it often. Many common questions can be answered by reviewing the relevant chapter. Download the Supplier Manual from your specific region at the links below:

Region A, NHIC,

Region B, NGS,

Region C, CGS,

Region D, Noridian,

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