How to start a DME business FAQ’s
Here are a few frequently asked questions
DME F.A.Q
Where do I buy my medical supplies? What medical supplies manufacturer should I contact? How do I locate a medical supplies manufacturer?
These are one of the most common questions we get on a daily basis. We have a list of manufacturers that will work with you and will get you medical supplies. We have contacts with great manufacturers that will give you the knowledge of their equipment. All this is included in our consultation program
How to bill for DME ( medical equipment)? What are the billing codes for each medical equipment? How to bill for medical supplies?
This can be a stressful task. Billing and knowing all the bill codes (HCPCS codes) for each individual medical item can be overwhelming because there are over 500 codes in the medical equipment field. We will teach you the specific codes you will be billing and give you each bill amount for each HCPCS code.
How do I know what allowable amounts to bill for medical supplies?
Many healthcare insurances have their own allowable amounts. Allowable amount means the allowed amount they will reimburse you for each medical equipment you will be billing for. We will give you the knowledge on how to bill within the allowable amounts.
How do I look up the Medicare allowable amounts for DME medical supplies and equipment? How much does Medicare pay for medical supplies I want to bill for? How do I know if Medicare will pay on a purchase or on a rental for medical supplies and equipment?
Medicare has their own allowable amounts that they will reimburse you for each medical supplies you want to bill. Once you have established a Medicare accreditation, we will give you the knowledge on how to bill Medicare with each allowable amounts weather it be on a purchase or on a rental.
How can I get more medical supply orders from clinics or physicians?
This question is often asked by many of our clients. There are ways to market out your DME business within your city or online with website presence. Remember that when you open any business, location plays a big part of how well your business thrives within a city. It’s also known and said as, “location location location”.
How much money or capital do I need to get a medical supply business started?
This all depends on your own financial availability. Like with any business, you have to have a good capital to start with. If you are looking into getting a location and building a DME store front (brick and mortar) you will need a good amount of capital to buy equipment, furnish your store, monthly rent, ect… If you are looking into building a website and only want to sale DME products online you will also need to create a good domain name that is marketable within the DME field. A domain name is like choosing a location for your store front. We recommend a branding manager that will build you a good website along with a web based store so you can take advantage of the world wide web and reach a larger audience that is looking for medical equipment/ supplies.
We have an entire data base of DME names and DME websites for sale. These DME names and websites are part of our marketing and branding package. Please contact us for more details
How do I bill for medical supplies and equipment in my state?
If you are billing for medical equipment to PPO insurances, you will need to know all the billing codes that pertain to each medical equipment you want to bill for. Each insurance has their allowable bill amounts and you will need to abide by their allowable amounts. Our consultant will guide you in learning all the bill codes so you can effectively bill the correct codes.
I am a current provider (Chiropractor, Physician, Physical Therapist, Pharmacist, Respiratory Therapist, Registered Nurse, LVN) Can I add DME to my practice or start a medical supply business?
Yes you can! Since you already know the healthcare industry you will fall right into the DME industry easily. You can service your patients with all kinds of medical supplies and offer more services. The more services you offer in your clinic, the better patient outcome you’ll have! You can dispense DME to your patients right from your facility. You’ll need staff to handle this department for you and we can train your staff on how to effectively proceed with billing and deliver DME to your patients. Adding DME to your already existing clinic can generate more profits for you instead of out sourcing your DME orders to another company. Keep it all in house!
How do I get a medical supplier license in my state?
Every state has their own rules and regulations for a DME medical supplies license.
The regulation of businesses providing Durable Medical Equipment (DME) or Home Medical Equipment (HME) is dependent upon the types of equipment, as well as the jurisdiction. Since the term DME covers a wide array of devices, from crutches to catheters to wheelchairs to blood glucose monitors, it may not always be clear for businesses whether they must be licensed in a particular state. Additional permitting may be required for certain types of equipment (e.g. a Pharmacy License for oxygen-related devices). Start DME, LLC will streamline the process of determining and obtaining the proper DME licenses for your DME business. We provide comprehensive research regarding Durable Medical Equipment (DME) license requirements, and we prepare error-free application packets, minimizing time-consuming and costly delays.
DME suppliers are governed by stringent federal and state laws, particularly those that participate in the Medicare/Medicaid program. Initially, if a license is determined to be required, a DME company must obtain an “in-state” or a “resident” license. This generally requires an extensive application, varying fees, proof of insurance, and an inspection, which is usually scheduled upon approval of the application. If the company wishes to expand into another state, it must obtain an “out-of-state” or a “non-resident” license in that state. This process is more of the same, but also may require verification that the business currently holds a resident license (or proof that a license is not required) in the home state.
DME providers include DME companies, home health agencies, physicians, and other practitioners. The fact that you are a licensed home health agency or physician/practitioner does not exempt you from DME licensure. The State Board of Pharmacy of Department of Health generally issues licenses.
Ramifications of Non-Compliance
A company providing Durable/Home Medical Equipment without proper DME licenses may be subject to civil and criminal penalties. Companies must be particularly careful to ensure that their employees are properly licensed if they are going to be setting up or installing any of the equipment being provided. In many cases, companies have incurred heavy fines as a result of unlicensed employees.
How we help your business:
We stay up-to-date with changing requirements and forms so you can focus on the job at hand.
We complete license applications efficiently and correctly, allowing your in-house staff to save valuable time struggling to obtain the proper DME licenses.
Once your license has been issued, we ensure that you remain compliant with all DME licensing laws.
If you have any more questions, fill out the form bellow and one of our team members will contact you soon
What is Competitive Bidding?
You may have heard of the CMS DMEPOS Competitive Bidding Program. This program essentially coordinates the payment and dispensability of certain products/product categories to Suppliers that have won their bid for their area of coverage. As of 2022, the only product categories contained in the Competitive Bidding Program are Off-the-Shelf (OTS) Back and Knee braces. All previous categories that were under Competitive Bid are now freely able to be dispensed by Licensed and Accredited providers without the need to win a contract bid. For more information visit: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSCompetitiveBid
Do I need to get my medical supply store/ facility accredited by an accreditation company?
No, you do not need accreditation for your DME facility. It’s not a must but it sure does make it a lot easier to be an IN-NETWORK provider for any PPO Health care insurance company. Remember that if you are out-of-network, your patients might not have out-of-network coverages so it’s always best to be an in-network provider. This also applies to Medicare. If you are looking into becoming a Medicare provider it’s always best to get accredited through an accreditation company, and will give your DME business that much of a rapport when applying for any healthcare insurance including Medicare/Medicaid.
What are some potential set-backs in a DME business?
Some set-backs in a DME business can be overwhelming. One of the biggest set-backs in a DME business is billing! Billing the wrong codes, the wrong diagnosis, or submitting wrong chart notes, or not enough chart notes can set you back. You can find yourself waiting 30 days to years to get reimbursed for medical supplies you billed wrong for. This is why we exist! We are here to teach you every step of the way so that you don’t have ANY set-backs! We also provide billing services for your DME business. Fill out our form and we will get in touch with you.