Reference Guide DBidS

Transcription

1 Reference Guide DBidS DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) Bidding System

2 Contents Introduction 1 Form B Getting Started 2 Screen 8: Application Status 28 Tips 2 Screen 9: Create Bid 29 Screen 10: Business Organization 30 Form A Screen 11: Furnished Items 31 All Business Types (Single Location, Multiple Locations, or Networks) Screen 12: Expansion 32 Screen 1: Business Organization Information 4 5 Screen 13: Bid Sheet 33 Screen 2: Location Specific Information 6 7 Screen 14: Manufacturer 34 Screen 3: Location Specific Information Page 2 8 Screen 15: Manufacturer, Model Name Screen 4: Location Specific Information: 9 and Model Number 34 CBA and Product Category Screen 16: Summary 35 Screen 17: Bid Certification Statement 36 Multiple Locations Screen 18: Public Address Announcement 37 Screen 1: Location Summary 12 Screen 19: Certification 38 Screen 2: Additional Locations Screen 20: Status 39 Screen 3: CBAs and Product Categories 15 International Keyboard Networks Screen 1: Location Summary 17 & Alt Control Instructions 40 Screen 2: Network Member 18 Screen 3: Network Member (continued) 19 Screen 4: Additional Locations Screen 5: CBAs and Product Categories 22 Screen 6: Network Member (continued) 23 All Business Types (Single Location, Multiple Locations, or Networks) Screen 5: Application Summary 24 Screen 6: Checklist 25 Screen 7: Approval 26 DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November 2009

3 Introduction The following guide provides step-by-step instructions for entering or modifying a bid using the DBidS application. Before completing the application and submitting a bid, all bidders should carefully review information such as the Request for Bids (RFB) instructions, bidding charts, financial documentation requirements, and state and local licensure rules on the DMEPOS Competitive Bidding Program website at For more detailed information regarding entering a bid into DBidS, please refer to the DBidS User Guide available on the DBidS Welcome screen (see screen below). DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

4 Getting Started You must be registered and have received your IACS (Individuals Authorized Access to the CMS Computer Services) system user ID and password by the time registration closes. This will allow you to access DBidS. For more information regarding registration in IACS, please visit the Competitive Bidding Program s website at: To log into DBidS: Go to Click Suppliers Select Bidding Process Click Enter Bid Submission System (DBidS) You will be directed to the IACS login page Type your IACS user ID into the User ID field Type your IACS password into the Password field (IACS user IDs and passwords are case sensitive) Click Login Click Enter DBidS If this is your first time logging into DBidS, the Form A: Business Organization Information screen will appear. If you have previously logged into DBidS and completed this screen, the Status screen will appear. If you have more than one National Supplier Clearinghouse (NSC) number in IACS, the NSC Number Selection screen will appear. You will find an icon ( ) in the upper right corner of many of the sections throughout DBidS. Click on this icon for additional helpful information. Tips After keying information into any page in DBidS, it is always a good idea to save your entry by clicking Save. Do NOT hit Enter. This will cause the screen to reset and your information will be lost. Make sure you click the appropriate button (such as Save, Back or Next). Error messages may display at the top of the screen in red. If you modify any information in Form A or Form B after the bid (Form B) is certified, the Authorized Official (AO) or Backup Authorized Official (BAO) will need to re-approve Form A and re-certify Form B. If the DBidS application times out, you must completely close the browser you are currently in and open a new browser to log back into DBidS. You may also call the Competitive Bidding Customer Service Center from 9:00 a.m. to 9:00 p.m. ET, Monday through Friday, at for assistance. The screens and sections in DBidS are not numbered. The screens are numbered in this guide to assist you with using the guide. If using special characters, please use the International keyboard to enter the information (see page 40). DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

5 Form A IMPORTANT All suppliers (those with a single location, multiple locations, or networks) complete screens 1 4. AOs and BAOs must complete the Business Organization Information section ( 1 ) from page 4. Please note only one user may enter data in Form A at a time. Form A must be completed and approved by the AO or BAO before data may be entered on Form B. * Please note that the screens and sections in DBidS are not numbered. These numbers are to assist you with using this guide only. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

6 Form A The Form A: Business Organization Information screen requests general information about your business. Screen 1*: Form A Business Organization Information Business Organization Information Provide the supplier s legal business name that is reported to the Internal Revenue Service (IRS) for tax reporting purposes. Click the drop-down arrow and select one of the following: Supplier with single location Suppliers with only one location and NOT bidding as part of a network. Suppliers with multiple locations Suppliers with more than one location and NOT bidding as part of a network. Network supplier Small suppliers that are submitting a bid as part of a network. A network can have a minimum of two (2) and a maximum of 20 network members (including the primary supplier submitting the bid(s) on behalf of the network). The Network Name box appears when this option is selected. Specialty Supplier Only skilled nursing facilities (SNFs) and nursing facilities (NFs) are eligible to bid as specialty suppliers if they intend to provide competitively bid items to only their residents. If you choose Yes and identify your business as a specialty supplier, you will only be allowed to bid on enteral nutrition. If No is selected and the SNF or NF wins a contract, the SNF or NF must provide the product category to any Medicare beneficiary residing in or visiting the competitive bidding area (CBA). If a SNF or NF is not selected as a contract supplier, it must use a contract supplier for the CBA to furnish competitively bid items to its residents. This response cannot be changed once the bidding window closes. * The screens and sections in DBidS are not numbered. These numbers are to assist you with using this guide only. 3 Accreditation All supplier locations must be accredited for the product category for which the supplier is submitting a bid. As required by 42 CFR (c) of the final rule, each supplier location must meet quality standards and be accredited in order to be awarded a contract. This includes all product-specific standards. For a list of the Centers for Medicare & Medicaid Services (CMS)-approved organizations and additional accreditation information, visit: If No is selected in the Accreditation section, you will receive the following message: Are you sure? Each location(s) must be accredited in order to submit a bid. If you say OK, you may not continue. If you click OK, you will be logged out of DBidS. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

7 Screen 1*: Form A Business Organization Information (continued) 4 Contact Person Provide a maximum of five (5) persons who should be contacted to answer questions regarding your bid. The contact person may or may not be an authorized official or key personnel. However, this person must have the authority and knowledge to answer questions about your organization. The information will appear in the Modify/Delete Contact Person(s) section, and the Contact Person section is cleared to allow entry of additional contact persons. Repeat the same procedure to add personnel. You may modify this section to add or delete information. Please note that once deleted, the information is permanently removed from the application * The screens and sections in DBidS are not numbered. These numbers are to assist you with using this guide only. 5 6 Authorized Official and Key Personnel You may list a maximum of five (5) authorized officials and key personnel per business organization. The authorized official is the person(s) identified on the CMS-855S enrollment form submitted to the NSC. The authorized official has the legal authority to submit a bid on behalf of the company and to enter into a contract with Medicare to provide competitively bid items to Medicare beneficiaries. Key personnel are crucial to the operation of the business organization but are not authorized officials as described above. The information will appear in the Modify/Delete Authorized Official/Key Personnel Information section, and the Authorized Official and Key Personnel section is cleared to allow entry of additional personnel. Repeat this procedure to add personnel. You may modify this section to add or delete information. Please note that once deleted, the information is permanently removed from the application. Competitive Bidding Area (CBA) and Product Category Identify all of the CBA(s) and product category(s) for which your organization is submitting a bid. Please note that later in the application you will be required to identify the CBAs associated with each of your locations. A minimum of one (1) CBA and one (1) product category must be selected. Failure to do so on this screen will result in the CBA and product category not being available for location selection and bid submission later in the application. Please review the list of ZIP codes included in each CBA prior to completing this section. This list is available on the Competitive Bidding Program website at Note: Not all ZIP codes included in a county may be in a CBA. Each CBA will be listed twice with either a mail-order or non mail-order indicator. The product category(s) that will appear after the CBA is chosen depends on the CBA selection made. If you select a CBA with mail-order indicated, only the diabetic supplies product category will appear. If you select a CBA with non mail-order indicated, all of the product categories except diabetic supplies will appear. The support surface product category will only appear for the Miami CBA. Note: If you previously selected Specialty Supplier and then choose a CBA with the mail-order indicator, no product categories will appear in the product category section. Click on the Add CBA/Product Category button after selecting the CBA and product category from the CBA/product category drop down menu. This information will appear in the CBA/Product Category List section below. You will then be able to select an additional CBA/product category from the Competitive Bidding Area (CBA) and Product Category section. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

8 Screen 2*: Form A Location Specific Information The Form A: Location Specific Information screens request information for each location in your business organization. 1 Identifying Information Please note that the legal business name as well as the NSC number you previously provided when you registered in IACS will appear on the screen. You should provide information in this section for the location identified by the NSC number that is on the screen. Do not provide information for a billing agency, management service organization, or staffing company. The mailing address must be the same as the mailing address on file with the NSC and must correspond with the NSC number for this location. The business telephone number should only contain 10 numeric digits. The NSC and National Provider Identifier (NPI) numbers should be entered without dashes, slashes, or spaces (example: ). 1 2 Physical Address Complete this information if the physical address is different from the mailing address provided in the section above. If it is the same, the box must be checked to populate the address. A post office box is not accepted as a physical address. The physical address should be the same as the physical address on file with the NSC and must correspond with the NSC number on the screen Business Information Provide the Tax Identification Number (TIN) issued by the IRS. Sole proprietors may use their Social Security number. Social Security numbers should be entered without dashes. Provide the total number of years and months this location has been in business. This may or may not be the same time the business has been billing Medicare. If the number of years is greater than 99, select 99 years and 11 months. 3 Contract suppliers that wish to have their DBA (doing-business-as) name listed in the Supplier Directory on the Medicare website ( must have this information on file with the NSC. The Supplier Directory is populated with data provided by the NSC, not by DBidS. * The screens and sections in DBidS are not numbered. These numbers are to assist you with using this guide only. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

9 Screen 2*: Form A Location Specific Information (continued) * The screens and sections in DBidS are not numbered. These numbers are to assist you with using this guide only Type of Business Select one response. Corporation Sole Proprietorship Partnership Non-Profit Organization Municipality Owned Click on the icon for business type definitions. Service Delivery Check all delivery methods that apply: Retail Mail Orders Home Delivery Sanctions If Yes is selected, enter a description of any previous or current sanctions (maximum of 1,000 characters). If using special characters, please use International keyboard or Alt Control keys to enter information. (International keyboard and Alt Control instructions may be found on page 40.) DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

10 Screen 3: Form A Location Specific Information Page 2 Accreditation Accreditation Information After you select your accreditation status, the product category box will appear. Enter the issue and expiration date with the two-digit month and four-digit year (example: 02/2009). Not keying the date in this format may result in an error message. The data will then appear in the Modify/ Delete Accreditation Information section. Click Add Accreditation to clear the Accreditation Information section to allow entry of additional information. Repeat this procedure to add data. You may modify or delete the information in this section. Please note that deleted information is permanently re moved from the application. If you select Not Accredited and click Add Accreditation, the following message will appear: Are you sure? Each location must be accredited for the product category for which you are submitting a bid. If you say OK, you may not continue. Click Cancel to return to the previous screen. If you click OK, you are agreeing that you are not accredited, and you will be logged out of DBidS. Please note that if you enter accreditation information into this section and select Not Accredited, you will be logged out of DBidS. The information entered in this section will be verified with your accreditation organization. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

11 Screen 4: Form A Location Specific Information: CBA and Product Category CBA and Product Category The CBA(s) and product category(s) that appear in the drop down box are based on information previously provided from the Competitive Bidding Area (CBA) and Product Category section (see page 5, Screen 1). Once you choose the CBA from the drop down box, click Select to display the product categories for this CBA. Review the product categories and click Add CBA. The data will appear in the CBA and Product Category List section. The CBA and Product Category section is cleared to allow entry for additional information. Repeat this procedure to add CBAs. Suppliers are not required to maintain a physical location in a CBA to submit a bid for that CBA unless it is required to obtain state licensure. Suppliers must comply with all program requirements, including the requirement to furnish items to beneficiaries throughout the CBA, to be awarded a contract. A supplier should not submit a bid unless it currently has the ability to furnish items and services throughout the entire CBA. If a supplier intends to use the services of a subcontractor in order to provide services throughout the CBA, it must ensure the subcontractor is accredited, licensed, and only performs services consistent with 42 CFR (c). DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

12 IMPORTANT At this point in the application, you will complete a series of screens depending on whether your company has a single location, multiple locations or is part of a network. > If you have a single location, please skip to page 24. > If you have multiple locations, please complete Screens 1-3 on pages Once these screens are completed, skip pages (these apply to network suppliers only), and continue to page 24 (Screen 5). > If you have a network, please skip to page 17 and complete Screens 1-5. Once these screens are completed, continue to page 24 (Screen 5). Beginning on page 24 with Screen 5, the application is the same for all types of bidding suppliers. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

13 Multiple Locations DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

14 Multiple Locations Screen 1: Form A Location Summary Companies with multiple locations that are solely owned or commonly owned and/or commonly controlled should only submit ONE bid application that includes all locations that provide the product category in the CBA. Locations within the CBA as well as those outside the CBA that routinely furnish items to beneficiaries must be included on the bid application. Competitive Bidding Program regulations do not allow commonly owned or commonly controlled companies to bid against themselves. Commonly owned suppliers are those where one or more of them have an ownership interest totaling at least 5 percent in the other(s). The term ownership interest is defined as the possession of equity in the capital, the stock, or profits of another supplier. Commonly controlled suppliers are those where one or more of the supplier s owners is also an officer, director, or partner of another supplier. Commonly owned or controlled locations that do not provide any of the items within a product category either to Medicare or non-medicare customers should not be included on the bid for that product category. For example, if one location is a pharmacy that only provides enteral nutrition products and another location only provides Durable Medical Equipment (DME) items, separate bids using separate Form As must be submitted for the pharmacy location and the DME location. For more information, please refer to the Common Ownership and Control Fact Sheet on the Competitive Bidding Program website at Click Add Location to access the Additional Locations screen. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

15 Multiple Locations Screen 2*: Form A Additional Locations Provide the following information for each location identified by its unique NSC number displayed in section Identifying Information The information provided in this section may not be for a billing agency, management service organization or staffing company. The mailing address must be the same as the mailing address on file with the NSC and must correspond with the NSC number for this location. The business telephone number should only contain 10 numeric digits. The NSC and NPI numbers should be entered without dashes, slashes, or spaces (example: ). 2 Business Information Provide the total number of years and months this location has been in business. This may or may not be the same time the business has been billing Medicare. If the number of years is greater than 99, select 99 years and 11 months. 2 * The screens and sections in DBidS are not numbered. These numbers are to assist you with using this guide only. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

16 Multiple Locations Screen 2*: Form A Additional Locations (continued) 3 4 * The screens and sections in DBidS are not numbered. These numbers are to assist you with using this guide only. 3 Accreditation Information After you select your accreditation status, the product category box will appear. Enter the issue and expiration date with the two-digit month and four-digit year (example: 02/2009). Not keying the date in this format may result in an error message. The data will then appear in the Modify/Delete Accreditation Information section. Click Add Accreditation. The Accreditation Information section is cleared to allow entry for additional information. Repeat this procedure to add data. You may modify or delete the information in this section. Please note that deleted information is permanently removed from the application. If you select Not Accredited and click Add Accreditation, the following message will appear: Are you sure? Each location must be accredited for the product category for which you are submitting a bid. If you say OK, you may not continue. Click Cancel to return to the previous screen. If you click OK, you are agreeing that you are not accredited, and you will be logged out of DBidS. Please note that if you enter accreditation information into this section and select Not Accredited, you will be logged out of DBidS. The information entered in this section will be verified with your accreditation organization. 4 Sanctions If Yes is selected, enter a description of any previous or current sanctions (maximum of 1,000 characters). If using special characters, please use International keyboard or Alt Control keys to enter information. (International keyboard and Alt Control instructions may be found on page 40.) DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

17 Multiple Locations Screen 3: Form A CBAs and Product Categories The CBA(s) and product category(s) that will appear in the drop down box are based on information previously provided. Once you choose the CBA from the drop down box, click Select to display the product categories for this CBA. Review the product categories and click Add CBA. The data will appear in the CBA and Product Category List section. The CBA and Product Category section is cleared to allow entry of additional information. Repeat this procedure to add CBAs. Suppliers are not required to maintain a physical location in a CBA to submit a bid for that CBA unless it is required to obtain state licensure. Suppliers must comply with all program requirements, including the requirement to furnish items to beneficiaries throughout the CBA, to be awarded a contract. A supplier should not submit a bid unless it currently has the ability to furnish items and services throughout the entire CBA. If a supplier intends to use the services of a subcontractor in order to provide services throughout the CBA, it must ensure the subcontractor is accredited, licensed, and only performs services consistent with 42 CFR (c). After you complete Screens 1-3, you will see the Application Summary screen. (Skip to page 24). DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

18 Networks 16

19 Networks Screen 1: Form A Location Summary The primary network member should enter its additional locations if applicable. Do NOT enter other network members names or locations on this screen. If no locations for the primary member need to be added, click Next. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

20 Networks Screen 2: Form A Network Member The primary network supplier should enter each network member s business name in this section. A network can have a minimum of two (2) and a maximum of 20 members, including the primary network member. For more information about networks, please refer to the Request for Bid (RFB) instructions on the Competitive Bidding Program website at: DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

21 Networks Screen 3: Form A Network Member (continued) Each member that is added will be displayed in the Network Members window. Click Add Location located next to the network member s name to enter information for that member. Please note that there is no limit to the number of additional locations that can be entered for each network member. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

22 Networks Screen 4*: Form A Additional Locations Provide the following information for each network member: Identifying Information The information provided in this section may not be for a billing agency, management service organization or staffing company. The mailing address must be the same as the mailing address on file with the NSC and must correspond with the NSC number for this location. The business telephone number should only contain 10 numeric digits. The NSC and NPI numbers should be entered without dashes, slashes, or spaces (example: ). Business Information Provide the total number of years and months this location has been in business. This may or may not be the same time the business has been billing Medicare. If the number of years is greater than 99, select 99 years and 11 months. 2 * The screens and sections in DBidS are not numbered. These numbers are to assist you with using this guide only. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

23 Networks Screen 4*: Form A Additional Locations (continued) 3 4 * The screens and sections in DBidS are not numbered. These numbers are to assist you with using this guide only. 3 Accreditation Information After you select your accreditation status, the product category box will appear. Enter the issue and expiration date with the two-digit month and four-digit year (example: 02/2009). Not keying the date in this format may result in an error message. The data will then appear in the Modify/Delete Accreditation Information section. Click Add Accreditation. The Accreditation Information section is cleared to allow entry for additional information. Repeat this procedure to add data. You may modify or delete the information in this section. Please note that deleted information is permanently removed from the application. If you select Not Accredited and click Add Accreditation, the following message will appear: Are you sure? Each location must be accredited for the product category for which you are submitting a bid. If you say OK, you may not continue. Click Cancel to return to the previous screen. If you click OK, you are agreeing that you are not accredited, and you will be logged out of DBidS. Please note that if you enter accreditation information into this section and select Not Accredited, you will be logged out of DBidS. The information entered in this section will be verified with your accreditation organization. 4 Sanctions If Yes is selected, enter a description of any previous or current sanctions (maximum of 1,000 characters). If using special characters, please use International keyboard or Alt Control keys to enter information. (International keyboard and Alt Control instructions may be found on page 40.) DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

24 Screen 5: Form A CBAs and Product Categories Networks The CBA(s) and product category(s) that will appear in the drop down box are based on information previously provided. Once you choose the CBA from the drop down box, click Select to display the product categories for this CBA. Review the product categories and click Add CBA. The data will appear in the CBA and Product Category List section. The CBA and Product Category section is cleared to allow entry of additional information. Repeat this procedure to add CBAs. Suppliers are not required to maintain a physical location in a CBA to submit a bid for that CBA unless it is required to obtain state licensure. Suppliers must comply with all program requirements, including the requirement to furnish items to beneficiaries throughout the CBA, to be awarded a contract. A supplier should not submit a bid unless it currently has the ability to furnish items and services throughout the entire CBA. If a supplier intends to use the services of a subcontractor in order to provide services throughout the CBA, it must ensure the subcontractor is accredited, licensed, and only performs services consistent with 42 CFR (c). DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

25 Networks Screen 6: Form A Network Member (continued) Once the location is added, the location s NSC number for the network member displays below the member s name. Please review the information for accuracy. You may change information by clicking Modify or Delete. Please note that deleted information is permanently removed from the application. Click Next to continue to the Application Summary screen. (See page 24.) DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

26 Screen 5: Form A Application Summary You will see a summary of the information provided for each location on this screen. Carefully review this summary. You may make modifications by clicking Edit to return to that particular section of the bid application. If you are satisfied with the information, click Next. AOs and BAOs will see the Checklist screen. EUs will be returned to the Status screen. To review the summary for additional locations, scroll down to the last section of the Application Summary screen, labeled Additional Locations/Network Members/ Network Members Additional Locations, and select the NSC number. Next click Go. The information in the Additional Location Information screen will appear. To change any of the information displayed on this screen, click Edit. Note: Your bidder number is located at the top of this screen. Please remember that your bidder number must be included on every page of the required hardcopy documents that you submit. The required hardcopy documents are detailed in the Request for Bids (RFB) Instructions, which can be found on the Competitive Bidding Program website, under Suppliers > Bidding Process. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

27 u Screen 6: Form A Checklist Only the AO or BAO can view this screen, and only when all required fields on Form A have been completed. This screen provides a checklist of the required hardcopy documents. Please read this document carefully prior to submitting your hardcopy documents. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

28 u Screen 7: Form A Approval Only an AO or BAO may approve Form A. The user ID is the IACS/DBidS user ID. Form A must be completed and approved by the AO or BAO before Form B may be created or accessed. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

29 u Form B DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

30 Form B Note: If you are submitting bids for more than one product category/cba combination, you will need to create or complete a Form B for each product category/cba. Multiple users may be in Form B at the same time as long as each user is entering information for a different product category/cba. Screen 8: Form A Application Status The Application Status screen must display Complete and Approved before you can proceed to Form B. If this is displayed, click Create Form B located on the left side of the screen. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

31 Screen 9: Form B Create Bid The CBA and product category fields have been populated with information you provided on Form A. Choose the CBA from the drop down list and click Select. The product category(s) will then be displayed. Choose the applicable product category for that CBA and then click Create Bid. The information you selected will be displayed in the box in the lower part of the screen. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

32 Screen 10*: Form B Business Organization 1 Revenue from Product Category Select the total revenue that you collected for this product category in this CBA for the past calendar year. If you are submitting a bid for multiple locations that serve this CBA, select the total revenue for ALL locations. If you are bidding as a network, select the total revenue for this product category in this CBA for all network members. Select the percentage of total revenue for this product category in this CBA that was collected from Medicare for the past calendar year. Good faith estimates are acceptable Customers Served Enter the total number of all customers served in this CBA for this product category, not just the number of Medicare customers served, for the past calendar year. Select the percentage of that total number that were Medicare beneficiaries. Good faith estimates are acceptable. 3 Geographic Area Identify the counties in the CBA where you currently furnish this product category, not counties where you would furnish this product category if awarded a contract. 3 * The screens and sections in DBidS are not numbered. These numbers are to assist you with using this guide only. Indicate the percentage of this area where you currently serve Medicare beneficiaries. Note: CBAs are defined by ZIP codes. It is important to note that only portions of some counties may be included within a CBA. You may find a list of ZIP codes included in each CBA on the Competitive Bidding Program website ( under Suppliers > About the Program > Competitive Bidding Areas. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

33 Screen 11: Form B Furnished Items For each Healthcare Common Procedure Coding System (HCPCS) code, enter the number of units that you provided to all customers in the past calendar year, NOT the number of units you would provide if awarded a contract. Then enter the number of units you provided to Medicare beneficiaries. If you enter a number into Units Provided to Medicare Beneficiaries that is larger than the number that was entered into Total Units Provided, an error message will appear. To correct this error, you must increase the number in Total Units Provided first, and then delete the number in Units Provided to Medicare Beneficiaries. Next, delete the increased number you entered in Total Units Provided. Then re-key the correct information in both boxes. Indicate the percentage increase in Medicare business that your business organization or network would be capable of providing for all HCPCS codes in that product category for this CBA during a projected 12-month period. The percentage increase may exceed 100 percent. For the definition of a unit, please refer to the Bidding Information Charts on the Competitive Bidding Program website ( under Suppliers > Bidding Process. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

34 Screen 12*: Form B Expansion 1 Expansion Plan Complete this screen if you plan to expand your business under the DMEPOS Competitive Bidding Program. If using special characters, please use International keyboard or Alt Control keys to enter information. (International keyboard and Alt Control instructions may be found on page 40.) If the text box is not large enough to accommodate the information, you may use the Additional Information field. You may also include additional information with your other required hardcopy documents. Remember to indicate your bidder number on each page of any hardcopy documents. 1 2 Add Subcontractors Identify the legal name and expected function of any entities with which you anticipate entering into a subcontracting agreement. Suppliers participating in the Competitive Bidding Program must comply with the supplier standards set forth in 42 CFR (c). The supplier standards describe the services a Medicare enrolled DMEPOS supplier may subcontract to another entity. These functions include the purchase of inventory, the repair of rented equipment, and the delivery and/or instruction on the use of a Medicare-covered item. It is important to note that the supplier is 100% responsible for the delivery and instruction of Medicare-covered items and for maintaining the proper documentation, whether it contracts out this service or not. You must submit your signed subcontractor agreements in hardcopy; the subcontractor agreements are not entered into DBidS. If you are awarded a contract, you must notify CMS of any subcontracting relationships you have entered into for purposes of furnishing items and services under the program. You must also disclose whether the subcontractor meets accreditation and any state licensure requirements necessary to furnish these services. Contract suppliers are the party that will be held responsible for the items and services they provide directly or through the use of a subcontractor. 2 * The screens and sections in DBidS are not numbered. These numbers are to assist you with using this guide only. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

35 Screen 13: Form B Bid Sheet You must enter the total estimated capacity and bid price for each HCPCS code or product class. Product Class is only applicable to the oxygen product category. When bidding on the oxygen product class category, you will only submit a single bid price for the payment class or combination of codes. The Rental or Purchase column tells you whether to submit your bid price as a rental or as a purchase of a new item. Rental means to enter your bid price for one month s rental of the item. Purchase means to enter the bid price as the total purchase of the new item. For the oxygen product category only, you will bid by class based on the rental for one (1) month. The Product Weight indicates the relative market importance of the item within the product category. To determine the Total Estimated Capacity for each HCPCS code or payment class, calculate the number of units that you currently furnish on a yearly basis and add any additional number of units or capacity you would be capable of providing annually at the start of the contract period. Do NOT report your estimated capacity for the entire contract period. The definition of a unit for each item in the product category may be found on the Competitive Bidding Program website, under Suppliers > Bidding Process > Bidding Information Charts. The Bid Price must not exceed the fee schedule amount and must be rational and feasible. It must also include the cost of furnishing the item throughout the CBA. If there is a question about a bid price during bid evaluation, you may be requested to provide supporting documentation, such as a manufacturer s invoice, to verify that you can provide the item for the amount indicated on Form B. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

36 Screen 14: Form B Manufacturer < Provide the manufacturer, model name, and model number for all products you will make available to Medicare beneficiaries in the CBA for each of the identified HCPCS codes. You must provide a minimum of one entry per HCPCS code. If you do not currently provide the item, you should provide information for the item that you intend to furnish if awarded a contract. Screen 15: Form B Manufacturer, Model Name and Model Number When you click Add, this screen will appear. Enter the manufacturer, model name and model number information for the HCPCS code. Click Add Manufacturer, Model Name & Model Number to add the information to Form B. Once completed, you must click Back to return to the previous screen so that you may enter manufacturer, model name and model number information for the other HCPCS codes in the product category. This information will be displayed in the Supplier Directory on the Medicare website at < DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

37 Screen 16: Form B Summary The Summary screen displays all of the information entered into Form B. Please scroll down the page to review each section carefully. If you need to make changes or updates to a section, click Edit for that section. This will return you to the selected screen to make any changes. If you are satisfied with the information listed on the Summary screen, click Next. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

38 Screen 17: Form B Bid Certification Statement The AO or BAO should read the certification statement carefully. Click Next to read the penalties for falsifying information. Form B must be certified in order for your bid to be submitted. Note: Form B required fields must be completed and the AO or BAO must certify Form B. The primary supplier for a network must print the certifying statement for each member. Each member must carefully read and sign the statement. The primary supplier must submit the certifying statements of all members with the network s hardcopy documents. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

39 Screen 18: Form B Public Address Announcement Once you have carefully read this public address announcement, click Next. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

40 Screen 19: Form B Certification Form B must be certified by the AO or BAO. The user ID is your IACS/DBidS user ID. If any modifications are made to Form B after it is certified, the AO or BAO must re-certify Form B. If Form B is not certified, your bid cannot be evaluated, and you will not be considered for a contract. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

41 Screen 20: Form A and Form B Status This screen indicates the status of Form A Status is defined as follows: Form A and Form B of your application. Incomplete Form A is missing required information. It is the responsibility of the bidding Pending Approval Form A has not been approved by the AO or BAO. supplier to submit all required hardcopy Complete and Approved Form A is complete and has been approved documents to the CBIC. The Docuby the AO or BAO. mentation Status section indicates whether a package of documents has Form B Status is defined as follows: been received. It does not indicate Incomplete Form B is missing required information. whether the package is complete or the Pending Certification Form B has not been certified by the AO or documents are accurate or acceptable in BAO. A bid (Form B) that is not in a certified status will not be considered accordance with the RFB requirements. for evaluation. Complete and Certified Form B is complete and has been certified For more information on the required by the AO or BAO. hardcopy documents, please review the RFB and financial instructions Documentation Status is defined as follows: found on the Competitive Bidding Documentation Received Yes displays if the CBIC has received Program website at: a package; No displays if the CBIC has not received a package. Date Received Displays the date received. DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November

42 International Keyboard & Alt Control Instructions International Keyboard Click Start in the bottom left of your screen. Select Settings, then Control Panel. Double click Regional and Language Options. A box will appear. Select the Languages tab. Click Details. In the Installed services box, click Add and select United States-International under Keyboard Layout/IME. Click OK. Click Apply. Alt Control Hold down the Alt key while typing the corresponding key combinations indicated in the box below (use the numeric keypad to enter numbers.) Character Description Windows Macintosh inverted exclamation mark 173 opt-1 inverted question mark 168 opt-shift-/ á small a, acute accent 160 opt-e A Á capital A, acute accent 0193 opt-e shift-a é small e, acute accent 130 opt-e E É capital E, acute accent 144 opt-e shift-e í small i, acute accent 161 opt-e I Í capital I, acute accent 0205 opt-e shift-i ñ small n, tilde 164 opt-n N Ñ capital N, tilde 165 opt-n shift-n ó small o, acute accent 162 opt-e O Ó capital O, acute accent 0211 opt-e shift-o ú small u, acute accent 163 opt-e U Ú capital U, acute accent 0218 opt-e shift-u DBidS Quick Reference Guide DMEPOS Competitive Bidding Program VERSION 1.0 November