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Do I Need A DME License?

Many doctors already dispense supplies and durable medical equipment (DME) from their offices for patient use. Others generally write a prescription and send the patient to a DME provider. This is a lost source of revenue for the practice. Having DME and supplies available in the office is very convenient for patients and is a great way to increase patient satisfaction.

The Patient experience is much better when they can get diagnostic tests in the office. This eliminates the need to go to another facility to receive those additional services and reduces the need to take additional time off work, etc. Simply put, it is much more convenient for the patient. The same applies to dispensing durable medical equipment. It is convenient, saves time and improves the overall patient experience. By dispensing durable medical equipment in your practice, you also have some level of control over the quality of the items you dispense, ensuring your patient is getting the device you want and not some other company’s version or an inferior product.

In order to dispense Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS), one must have a Durable Medical Equipment Regional Carrier (DMERC) license to dispense covered items for Medicare patients.

What Is The Difference Between Providers And Suppliers?

The Medicare program consists of three parts. Part A essentially covers hospital care while Part B covers provider services. The third component is providing medical supplies and equipment for patients. Keep in mind that in the DMERC system, physicians, chiropractors and other practitioners are not considered doctors but are classified as suppliers. The practitioner can act as both the provider requesting the item and the supplier of the item.

A practitioner may be a participating supplier or a non-participating supplier. The preferred designation is not affected by the Medicare part B status. You can be a participating provider in Medicare Part B and a non-participating supplier for DMERC or vice versa.

Being a participating supplier means accepting assignment on all cases. The system pays 80 percent of the allowable fee (after the deductible has been met). One may collect the 20 percent patient portion and any deductible when dispensing the DME item/supply. A non-participating supplier can elect to accept assignment or not on a case-by-case basis. The non-participating supplier may collect the entire fee when they have dispensed the item/supply. The Medicare payment check would then be sent to the patient.

How To Become A DMERC Provider

There are various requirements to acquiring a DME license. These include posting hours of operation on the door of the office, keeping a log of complaints, and having a complaint protocol including a complaint form for the patient to fill out. Suppliers are also required to have a DMERC Supplier Guidelines binder. Suppliers must also confirm with their malpractice insurance carrier that the DME license carrier is listed as a certificate holder on the policy.

The final step in the application process is an in-person inspection of your office prior to you obtaining your DME license. If you are ready to start the application process or just have questions, please call us at (800) 718-2218 to speak to one of our DME licensing agents.

 

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