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National Supplier Clearinghouse (NSC)

The NSC issues supplier authorization numbers to HME providers. This is your first stop if you want to become a Medicare supplier. You must fill out an application and mail it to the NSC. If your application is complete; if you are in compliance with all 21 Supplier Standards approved by the Office of Management and Budget (OMB); and if a site visit from an NSC investigator goes well, you will receive your NSC number in about 8 to 12 weeks.

The main responsibility of the NSC is to keep accurate, up-to-date records on all suppliers nationwide in order to help prevent fraud and abuse of the Medicare system. The NSC must be contacted if you have any changes in your address, phone number, etc. and also if there is a change of ownership or if you are going out of business. The NSC will send you a re-enrollment package every 3 years after you receive your number. It is your job to complete and return the requested information to the NSC within 35 days or your supplier number will be turned off and your claims will be denied.

You are required to have an NSC number in order to bill Medicare, so it is important to maintain valid information with the NSC. If your number is inactivated for any reason, any claims that you bill to Medicare will be denied. Some possible reasons for have your number inactivated are not complying with any one of the Supplier Standards, not sending in your re-enrollment form in on time, or not doing any billing for four quarters in a row. You may appeal this decision to inactivate your number, but you will not be able to do any billing until it is reinstated and you will have to resubmit all claims that were denied once your number is activated again.

The NSC also establishes your participating status with Medicare by way of a contract that you sign indicating that you agree to accept assignment on all claims that you bill to Medicare. This contract is effective for 12 months at a time, starting with January 1st. You may change your status from year to year, but it remains the same throughout the 12 month period. If you sign this agreement, you are considered a participating provider. If you do not sign this agreement, you are considered non-participating, and you may choose whether or not you want to accept assignment on each claim that you bill. Remember that when you accept assignment, you acknowledge that you will accept Medicare's allowable as full payment, and the amount paid by Medicare will be sent to you, the provider. If you do not accept assignment, it is your responsibility to collect the amount owed from the patient.

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