DME Billing Services For Suppliers From Order To Resupply.
Equipment claims are paid on paperwork as much as on the item: a complete written order, the right encounter, approval where required, proof of delivery and refill rules that run for months. We check the document trail before each claim and track rentals and resupply over time.
- Orders, delivery and resupply
- Rental months and modifiers tracked
- Product categories confirmed first
A missing document at any step can sink the claim, even after delivery. No real patient or claim data.
Your Supplier TeamDocuments each delivery
Five Documents Payers Can Ask For.
Medicare's DMEPOS rules, which many other payers follow, separate who supplies what. Your team gathers them; we check them against each claim.
| Document | Comes from | What it must contain |
|---|---|---|
| Standard written order | Ordering practitioner | Patient name or Medicare ID, order date, item description, quantity, practitioner name or NPI, and signature |
| Face-to-face encounter | Ordering practitioner | For items on Medicare's required list: a recent visit documenting the need, before the order |
| Prior authorization | Requested by the supplier | For items on Medicare's required prior authorization list and many commercial plans |
| Medical records | Practitioner's chart | Clinical support for the item and any coverage criteria |
| Proof of delivery | Your supplier team | Signed delivery slip or shipping record, matching item, quantity and date |
Rentals Run On A Clock.
Many items are rented month by month, and the modifiers change as the rental progresses.
Thirteen Months, Then Ownership
After 13 continuous rental months, ownership usually passes to the patient. Breaks in service and changes of supplier affect the count.
New, Used Or Rented
Oxygen follows its own rental period and supplier obligations, so we track it separately.
Refills Follow A Strict Calendar.
Medicare does not allow automatic shipments. Each refill needs a confirmed need, inside a defined window.
before delivery, contact the patient to confirm need and remaining quantity.
before the current supply runs out, deliver the refill.
who confirmed, what remained and what was sent.
Medicare refill requirements. Commercial plans and Medicaid programs set their own.
Modifiers That Tell The Payer Your Story.
Criteria Met
The policy's coverage criteria are met and documented in the record.
ABN On File
You expect a denial and the patient signed an Advance Beneficiary Notice.
Denial Expected, No ABN
You expect a denial and no ABN was obtained. The patient cannot be billed.
Patient's Home State
Medicare DME claims go to the contractor for the patient's permanent address, not your location.
Enrollment And Accreditation Come First.
Billing Medicare for equipment requires an enrolled, accredited supplier meeting the DMEPOS supplier standards, with revalidation on a regular cycle. In competitive bidding areas, some items can only be billed by contract suppliers.
These are separate from billing. We confirm your enrollment, accreditation and product categories before we bill anything.
- Product categories and HCPCS codes you supply
- Purchases, rentals or recurring supplies
- Medicare enrollment and accreditation status
- Competitive bidding contracts, if any
- Your billing system and how delivery records are stored
Medical Billing Or Full RCM?
Medical Billing
Your team gathers orders, encounter notes, approvals and delivery records. We check each claim against them, track rental months and refills, and follow every response.
About Medical Billing Services →Full RCM
We also verify coverage, request prior authorizations and code each item, with credentialing support included where it applies.
About Full RCM →Supplier enrollment and accreditation are separate from billing. Prescriptions and patient records should never be sent through the website.
Questions DME Suppliers Ask.
Please keep prescriptions and patient records out of the form.
Which Documents Do You Need Before A Claim Goes Out?
The written order, any required face-to-face encounter and prior authorization, supporting records and proof of delivery. If one is missing, we name the claim and the document.
Do You Track Rental Months?
Yes. We track each rental from month one, apply the right rental modifiers and flag breaks in service or supplier changes that affect the count.
How Do You Handle Resupply Claims?
We bill only when your team has documented the patient's confirmed need and remaining quantity, inside the refill window.
Which Product Categories Can You Support?
Send a business-only list of your categories and billing system. We confirm in writing which work the service covers.
Talk Through Your Order-To-Claim Workflow.
Tell us your product categories, rental and resupply mix, payer mix and billing system. Please keep prescriptions and patient records out of the form.
- Document trail checked before each claim
- BAA signed before any patient-data access
- Rentals and resupply tracked