Medicare Attestation Form

Urgent Notice from Medicare | ELIGIBILITY Action Required

CMS has a NEW initiative whereby CMS requests that Medicare SUPPLIERS (and only suppliers for now) attest to a known Medicare eligibility relationship via the Medicare DME MAC CEDI website. A confirmed form will be required to run eligibility in the next 6-12 months. Medicare sent a list of provider NPIs linked to our submitter number and your office is on the list. Please complete the form for all NPIs that are used during eligibility checks. Follow the below instructions to complete the form. Please let us know if you have any additional questions.

Client must also complete a HETS 3rd party Attestation Form

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Click on “Enrollment” > “HETS 3rd party Attestation Form”
Bonafide Unique Id: #4HRF