Many billers and administrative staff are well versed in claim denials related to things like missing or inappropriate modifiers, medical necessity, or even referring physician PECOS enrollment. One area that billers rarely anticipate is a claim denial that is directly related to the practice’s DMEPOS Supplier Enrollment application. These denials, although seemingly less common, can be more time-consuming to navigate and have significant financial implications.
One common misconception related to enrollment is regarding businesses that have expanded into multiple locations that are all linked to the same Tax Identification Number (TIN). Despite the commonality of the TIN, each location needs to be separately enrolled with Medicare and have its own Provider Transaction Access Number (PTAN) and National Provider Identifier (NPI). As separately enrolled locations, the claims must be separate as well. If a device is delivered out of Location A, the claim must be billed with the PTAN/NPI for Location A. Billing a claim that was delivered at one location with a PTAN/NPI for a different location is inappropriate and could jeopardize your Medicare enrollment status.1
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