Your Guide To Medicare’s Durable Medical Equipment, Prosthetics, Orthotics, & Supplies DMEPOS Competitive Bidding Progr

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Your Guide to Medicare's Durable Medical
Equipment, Prosthetics, Orthotics, Supplies
DMEPOS Competitive Bidding Program
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1. Lack of Understanding of the Managed Care
Contract
The Competitive Bidding Program by Medicare was
launched to improve the overall value of Medicare
and the money of the taxpayers used in the
facilities. The program sets prices through
competition, ensuring that the patients' items
are of quality and licensed. It also allows only
accredited suppliers to bid who must meet the
standards set by Medicare. The overall process
helps in reducing fraud and abuse of the Medicare
system. What Is DMEPOS Competitive Bidding
Program? Congress mandated the DMEPOS
Competitive Bidding Program in 2003 through
Medicare Prescription Drug, Improvement, and
Modernization Act (MMA). The Act required
Medicare to replace its then methodology of fee
schedule payment for selected Durable Medical
Equipment, Prosthetics, Orthotics, and Supplies
(DMEPOS) items with a competitive bidding
process.
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What Happens If A Patient Requires An Item Of A
Specific Brand?
If a patient needs DMEPOS items not mentioned in
the competitive bidding program, then the doctor
must prescribe the brand in writing. It is only
accepted when it can be established that there
can be an adverse medical outcome without using
the specific brand. In the document, the doctor
must record why the brand is needed and how it
can avoid a negative outcome. The contractor in
such a situation is then required to Give the
patient the specific brand of an item. If the
supplier doesn't have or cannot get it for the
patient, then they must help in finding another
contractor who can provide it. Work with the
doctor to find an alternative and then get the
prescription revised. Know more..
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4. Non-HIPAA CarriersHow To Get The Item
Repaired Or Replaced?
When a patient owns a competitively bid DMEPOS
item and needs to repair or replace the parts,
they can contact any Medicare-enrolled supplier.
Even a non-contract supplier can help repair and
replace the parts. But the supplier must be
Medicare enrolled so the patient can get the
reimbursement for the repaired or replaced parts
from Medicare. However, Medicare will not pay for
any replacement or repair covered by the warranty
of the item's supplier.
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Can The DMEPOS item Be Received from Doctor
or Hospital?
Typically you should get the item from a contract
supplier registered with Medicare. However, there
are exceptions like The doctor or the treatment
facility gives the equipment as part of the
clinical service during the treatment despite not
being a contract supplier. The doctor or the
hospital gives the item when the patient is
admitted or on the day of release from the
hospital. It can be done even when the provider
is not a contract supplier.
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How To Ensure Your Facility Is Benefitting From
The DMEPOS Competitive Bidding?
If you are into Durable Equipment facility
service and Medicare contracted supplier, then
all these new rules can be confusing. In such a
scenario, the best way to navigate the system is
to get help from an outsourcing medical and
billing partner such as 24/7 Medical Billing
Services to ensure your revenue management is in
place. It even wont be the last thing to run
into losses due to claim rejections as a Durable
Equipment provider.
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About Us
We are a medical billing company that offers
24/7 Medical Billing Services and support
physicians, hospitals, medical institutions and
group practices with our end to end medical
billing solutions. We help you earn more revenue
with our quick and affordable services. Our
customized Revenue Cycle Management (RCM)
solutions allow physicians to attract additional
revenue and reduce administrative burden or
losses.
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Contact Us
Media Contact 24/7 Medical Billing
Services Georgia 3001 Greenfield Drive, Marietta
GA Ohio 28405 Osborn Road, Cleveland, OH
4414030068 Texas 2028 E Ben White Blvd,
240-1030 Austin TX, 78741 Delaware 16192
Coastal Highway, Lewes, Delaware 19958, United
States Phone no / Fax [phone]
Email us info_at_247medicalbillin
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