dmerc deactivation?

[jennifer8055]

Has anyone ever had a provider's DME provider number be deactivated?  How long did the process take to be reactivated? 

When someone dropped the ball, so to speak, in updating/changing our address when we moved in 2013, we didn't find out until January 2014 that DMERC wasn't forwarding any of our correspondence because they "don't forward mail, even if you have a forwarding order." (I'm sorry.....what??)  Ok, so I understand that there have been "fly-by-night" clinics that have opened with the sole intention of committing Medicare fraud, but we are a physician group that has been in practice for more than 10 years with no complaints and no major issues.  Now we have to go thru the process of sending in a new application to be reactivated and have an inspector come out to see we are a TRUE DME supplier and play the waiting game for them to make a decision on whether or not we can continue to issue DME products AND if they are going to retro-active our date.

[Merry]

I think it will depend on your MAC.  I would call and ask.  I would imagine that they don't have lots of people doing site visits. 

[jennifer8055]

yeah....what little bit of information we've recevied has come from our MAC........can't tell us when someone will be out - which i understand, "surprise" inspections and all to catch certain providers off guard to make sure you're on the "up & up".

mainly what my doctors want to know is if anyone's had this happen before and if the MAC did retro-active the date the activation was done.

thanks!
jenn

[Michele]

I have seen providers be deactivated.  Could be for a couple reasons, one being if no claim was processed for them within a 1 yr period.  Another is if they don't respond to the revalidation request.  In your case, yes address change will definitely prompt a quick deactivation.  If you look at any envelope from Medicare or DMERC it says "DO NOT FORWARD" and yes it's to prevent fraud.  Medicare requires that a provider notify them of ANY changes, including address change, within 30 days of the change.


 In any case the amount of time to get reactivated varies depending on the MAC and what's happening.  I have seen them go through in 8 weeks and I've seen them go as long as 6 months.  Usually with a reactivation, if you respond quickly, no time is lost.  They simply reactivate the number and there is no period where the provider is not enrolled.  However, if too much time passes between the deactivation and the submission of the form to request reactivation, then money can be lost.

[jennifer8055]

thanks michele!  we're definitely hoping for the latter.  it just really sucks that the MAC makes no effort to contact us by any other means than mail.  phone call, certified mail, anything else??  nope, just snail mail.  we've sent in the re-validation "packet" overnight to the MAC and hopefully it won't take long to get an inspector out here and get everything back going.  we have ALOT of patients that we issue diabetic shoes/inserts to and to not be able to do that for awhile is going to hurt.

[Michele]

I would recommend that you check on the process often.  Many times they will request corrections or additional information by fax or email.  If you miss it, then they will close the application.  They only request information once.  If you send it in and it's not exactly what they ask for they will not tell you.  You MUST call and say "Did you receive everything that you requested and was it correct?"  So call every other week to check on the status.  Just my recommendation!