DME Credentialing

A Durable Medical Equipment (DME) Supplier or Home Medical Equipment (HME) is a business that sells or rents DME or HME. This type of equipment helps to manage chronic medical conditions that will typically last for 3 years or more, for example brace for Lumbar disc dislocation. It is advantageous for DME and DEMPOS (durable medical equipment, prosthetics, orthotics) suppliers to get credentialed with Medicare, since most patients who need that medical equipment have Medicare insurance.

To get credentialed with Medicare and other payers, you are required to be accredited with one of the CMS approved accreditation organizations https//cms.gov, it will verify if your business meets the required DEMPOS Quality Standards and conduct periodic unannounced site visits.

To get credentialed with Medicare and other insurance carriers DME and DMEPOS suppliers are required to fulfill following requirements:

  • Acquire a National Provider Identification Number for each location, if supplier has multiple locations of business
  • Tax ID
  • Obtain DMEPOS accreditation from a CMS-approved organization (https://cms.gov)
  • Pay the Medicare/Insurance Application Fee
  • DMEPOS Suppliers are required to post a surety bond in the amount of $50,000 for each NPI they maintain.

Once Credentialing application is submitted to Medicare, CMS will require accreditation organizations to prioritize their surveys of suppliers to accredit DME suppliers who will be participating in the Medicare DMEPOS Program. Suppliers should note that:

  • All surveys are conducted on site at the supplier’s location.
  • All surveys are unannounced.
  • Accreditation cannot be transferred upon merger, acquisition, or sale – the National Supplier Clearinghouse (NSC) and the Accreditation organization must be notified when these events occur.
  • Supplier will contact the deemed accrediting organizations directly based on the information provided at the CMS website.

CMM makes sure that DME/DMEPOS credentialing goes flawless and take following steps:

  • Complete enrollment application for DME/DMEPOS.
  • work with Medicare Administrator Contractor (MAC) for Medicare enrollment and credentialing department for commercial insurance carriers.
  • Continuous follow up with insurance carriers to get the updates on credentialing process.
  • We will not sign off until the provider receives a decision from the insurance carrier.