Is DME A Profitable Venture?

Is DME A Profitable Venture?

Until recent years, not really. The cost of the products versus having to track claims, find re-imbursements, and keep up with claims status; made DME a very labor intensive venture. With the advent of specialized DME/HME software, secure internet connections, and standardized billing procedures; DME can now be a very profitable venture.

In your practice, you will want to be sure that the product(s) you are dispensing are profitable. You need to watch the pricing of the product costs, in some instances, your product costs may be more than the carrier is willing to reimburse you for. When handling for Medicare patients, the process is much easier. The prices for DME supplies are easy to look up in the DMERC’s supplier manual.

For many claims you will need to obtain pre-certification to insure re-imbursement. Pre-certification is not a hard process, but it can be tedious. You can be rejected if your DME forms are not filled out absolutely accurately and completely. Medical billing firms who handle DME claims are very valuable in this respect, because the busier your practice is, the less time you have for filling out and following up on DME and other medical billing forms.

Fortunately for Medicare patients, very few items require pre-certification before billing as a DME claim. Formal Certificates of Medical Necessity (CMN’s) are required for certain items like wheelchairs, but are generally not required for items such as therapeutic shoes, surgical dressings or walkers.

If you watch your product cost when dispensing your DME’s and you have a good medical billing firm backing you up by handing your DME claims, you should have a very profitable venture indeed!

View all Articles by: Melissa Clark, CCS-P