The CMS site visit verification process is a screening mechanism to prevent questionable providers and suppliers from enrolling in Medicare. Providers and suppliers will be screened by the Centers of Medicare & Medicaid Services (CMS) designated national site visit contractor, with the exception of Durable Medical Equipment suppliers which are handled by the National Supplier Clearinghouse.
CMS is strengthening strategies designed to reinforce provider screening activities by increasing site visits to Medicare-enrolled providers and suppliers, enhancing and improving information technology (IT) systems, and implementing continuous data monitoring practices to help make sure practice location data is accurate and in compliance with enrollment requirements.
One important step in Medicare provider enrollment is a site visit.
CMS Site Visits
CMS has the authority to perform site visits on all providers. The site visits verify practice location information to determine compliance with enrollment requirements, and are required for moderate to high-risk providers during initial enrollment, revalidation and when a new location is added. Note that these verification visits are separate from any site visits required at the state level.
The visit is an external and/or internal review by an inspector, with limited disruption to your business. The inspector will introduce himself with a photo ID and a letter of authorization issued and signed by CMS and will:
- Take photos of the business.
- Observe that the business is in operation at that location.
- Verify that the facility is open and operational with both business personnel and customers present.
National Supplier Clearinghouse Site Visits for Durable Medical Equipment Suppliers
DME supplier enrollment site visits are required for initial enrollments and for revalidations.
The inspector will have photo ID, a letter stating the reason for the visit from the inspection manager and a site visit acknowledgement form.
During the visit, the inspector will take photos of your business and conduct an internal review to verify:
- Hours of operation
- Licenses and certifications
- Patient records
- Proof of business records such as rental agreements
- Inventory
Staff interviews may be conducted as well.
It’s important to give site inspectors your full cooperation and to answer their questions fully. Failure to do so, or to meet any verification requirements, may result in denial of your enrollment application and/or revocation of your Medicare billing privileges.
If you require medical credentialing and payer enrollment needs for your practice or medical facility, Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly.
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