The Centers for Medicare and Medical Services (CMS) requires Durable Medical Equipment, Prosthetic and Orthotic Suppliers (DMEPOS) to have a bond. New DMEPOS providers need to have this bond in place by May 4, 2009, while existing suppliers to file their bonds by October 2, 2009. The bond is required of those who bill Medicare for equipment they sell.

Download Application as PDF

Instructions:

If an applicant needs one bond, we will require the attached application completed and signed including:

1. The complete name and address for the applicant. Please note this is the name the bond will be written in.
2. National Provider Identification (NPI) and National Provider Transaction Access Number (PTAN) - also known as the Medicare Legacy Number per enrolled location.
3. Personal information on each owner of the business. This includes the name, address, social security number and verification whether he or she owns any real estate.
4. Business and Personal Indemnify of all owners and spouses.
5. Information regarding how long they have been in business.

If the applicant has been in business for less than three years, does not own real estate, or has more than one enrolled location and therefore needs more than one bond, the following additional information is required:

1. Information 1-5 from above.
2. A business financial statement
3. A personal financial statement from each owner.

Contact Information:
Vanner Insurance Group
11 Pinchot Ct
Amherst, NY 14228

Jason Reid
jreid@vannerinsurance.com
716-636-2271 or 716-688-8888 ext 288
716-929-8678 (Fax)

Colleen Kendziora
ckendziora@vannerinsurance.com
716-636-2271
716-929-1120 (Fax)