How do I send in a change of information?


Answer:
Supplier standard 2 requires suppliers to notify the NSC of any change within 30 days of the change.

To view sections of the CMS 855S for specific changes, see the Change of Information Guide.

The only two changes a supplier may submit on company letterhead are as follows:
  • To change its status from 'Participating' to 'Non-participating' during open enrollment. This request must have the original signature of the authorized or delegated official.
  • To voluntarily terminate its billing privileges. If a supplier has sold or desires to close its business for any reason, the supplier should request the billing privileges be terminated. This will assist in ensuring that the billing privileges are not used fraudulently. The request must specifically state that you are requesting to voluntarily terminate your billing privileges and indicate a date when the privileges should be terminated. The letter must also have the original signature of the authorized or delegated official.

We suggest that you submit a cover letter explaining what you are trying to accomplish. If there are several changes being submitted on the same form, a cover letter may assist the NSC analyst while processing.

Suppliers may submit a change of information to the NSC either hardcopy or electronically through PECOS. Mail the CMS 855S to:

National Supplier Clearinghouse
Palmetto GBA
AG-495
P.O. Box 100142
Columbia, SC 29202-3142

Overnight Mailing Address
National Supplier Clearinghouse
Palmetto GBA
AG-495
2300 Springdale Drive, BLDG 1
Camden, SC 29020



Last Updated: 03/01/2021