Credentialing & Compliance
Offshore Subcontracting Attestation
Contracted Medicare Advantage dental offices that subcontract with any offshore entities to process or have access to protected health information (PHI) are required by CMS to complete this attestation within 10 calendar days from the date a contract is signed or immediately upon knowledge of this requirement.
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Annual Compliance Attestation
We are required to monitor and ensure your organization operates in compliance with applicable laws and regulations required by CMS and your Participating Dentist Agreement. You must annually affirm your compliance with each of the listed topics in the attestation that apply to your organization and the services you provide for Medicare Advantage.
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Provider Contract Addendum
Providers participating in the Medicare Advantage Network must fill out and return a contract addendum. This can be found on the secure provider portal on the Documents tab. If you have any questions, please reach out to our provider relations team at 303-889-8677 or profservices677@ddpco.com.
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Exclusion Screening: Office of Inspector General (OIG) List of Excluded Individuals and Entities (LEIE)
OIG's LEIE provides information regarding individuals and entities currently excluded from participation in Medicare, Medicaid, and all other federal health care programs. You should check the list monthly to ensure that new hires and current employees are not on it.
OIG online databaseGeneral Services Administration (GSA) or System for Award Management (SAM) List
The GSA similarly maintains several exclusion lists, managed through the System for Award Management (SAM). You should routinely check SAM to ensure that excluded individuals and/or entities are not involved in provision of care services on behalf of your office.
SAM record searchCMS Preclusion List
CMS maintains a list of providers and prescribers who are precluded from receiving payment for Medicare Advantage items or services or Part D drugs furnished or prescribed to Medicare beneficiaries. You will receive an email and a letter from CMS/Medicare Administrative Contractors in advance of your inclusion on the preclusion list. The email and letter will be sent to your Provider Enrollment Chain and Ownership System (PECOS) address or National Plan and Provider Enumeration System (NPPES) mailing. The letter will contain the reason you are precluded, the effective date of your preclusion, and your applicable rights to appeal. Medicare Advantage plans are required to deny payment for a health care item or service furnished by an individual or entity on the preclusion list. To learn more about the CMS Preclusion List, visit CMS.gov.
