Medicare Claims Processing Manual (Pub. 100-04), Ch. 36 § 20.6.1.1.4

Notification to Beneficiaries for Suppliers that Choose Not to

Last amended: 2008Year: 2008Length: 414 wordsOfficial source
20.6.1.1.4 - Notification to Beneficiaries for Suppliers that Choose Not to Become Grandfathered Suppliers (Rev. 1532, Issued: 06-11-08, Effective: 07-01-08, Implementation: 07-07-08) A noncontract supplier that elects not to become a grandfathered supplier should provide notification to the beneficiary stating the supplier will not continue to furnish, after the start of the Medicare DMEPOS Competitive Bidding Program, the competitively bid item(s) that the beneficiary has been receiving from the supplier. This notification should meet the following guidelines: NOTE: This notification should only be sent to beneficiaries who the supplier is currently serving and who maintain a permanent residence in a CBA. The list of ZIP Codes for each CBA, the list of the HCPCS for competitively bid items, and the single payment amounts for these items are located in public use files on the CBIC Web site at: http://www.dmecompetitivebid.com/palmetto/cbic.nsf/DocsCat/Home. • It should state that the supplier will not continue to furnish rental DME and/or oxygen and oxygen equipment that it is currently furnishing to the beneficiary after the start of the competitive bidding program and that the beneficiary may need to select a contract supplier to continue to receive these items. • It should inform the beneficiary of the start of the competitive bidding program and the date the supplier plans to pick up the item. • It should inform the beneficiary that he/she may obtain information about the competitive bidding program by calling 1-800-MEDICARE or accessing www.medicare.gov on the Internet. It should also refer him/her to the supplier locator tool on www.medicare.gov. • The supplier should provide this written notification to the beneficiary 30 days before the start date from the implementation of the Medicare DMEPOS Competitive Bidding Program. • The supplier should inform the beneficiary of the end date of service and that arrangements will be made to pick-up the item within 10 days of picking up the item. • The supplier should remind the beneficiary of the date and time the equipment will be picked up within 2 business days of picking up the equipment. Recommended Schedule for Suppliers to Notify Beneficiaries to Locate a Contract Supplier Notification - Supplier Number of Days Before the Start Date of the Competitive Bidding Program Initial Notification in writing 30 days Notification before picking up equipment Within 10 days before picking up the equipment. Final Notification before picking up equipment Within 2 business days of picking up the equipment ** A sample notification letter will be posted on the CBIC Web site at www.dmecompetitivebid.com.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 36 § 20.6.1.1.4: Notification to Beneficiaries for Suppliers that Choose Not to | Justis AI