Confused? Start here.
If you are new to ordering medical equipment, this tutorial will get you up to speed in no time!
Home medical equipment (HME), also known as durable medical equipment (DME), is prescribed for a patient just like a drug. Many of the commonly prescribed devices are not available over the counter and must be dispensed by a DME supplier.
Insurance carriers, and Medicare, will cover most DME items when they are medically necessary. So, when referring a patient to Diamond, it is common to send the patients most recent examination reports and the prescription.
In general, to fill an order for medical equipment, you will need:
- A face sheet or other document that provides necessary demographic information about the patient
- The patient's most recent examination (History & Physical, progress note, etc.) that shows diagnosis and reason for the equipment ordered.
- A "Standard Written Order" (formerly known as a Detailed Written order, or DWO).
Addendum
The physician may amend their report to include information observed during the patient's visit but not included in the report. To do so, the physician creates a new document (typically titled "Addendum") that contains the patient's name, the date of the initial examination, the facts being added to the medical record, the physician's signature, and today's date.
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FAQ: Ordering & Delivery
Orders with complete documentation are typically delivered within 24 hours.
Most orders are delivered by our technicians. Some items may be shipped to the patient via UPS or USPS.
Once received, your order is entered into our tracking system, and you will receive a fax confirmation.
It typically takes us from 1-3 hours to enter and review your order.
If your order is complete, it will typically be dispatched for delivery on the following day.
If you are placing a STAT order (typically respiratory items), we will make every effort to deliver your item the same day. We will contact you and the patient/caretaker to discuss delivery.
If your order is missing an item, or the documentation does not meet the insurance (or Medicare's) requirements, you will receive a fax from us explaining the issue along with a proposed resolution. You must respond to this fax as soon as possible.
Medicare has specific requirements for medical equipment prescriptions. They refer to this prescription format as a Detailed Written Order or DWO.
A DWO contains the pertinent patient information, their MBI code, a complete description of the item(s) being ordered, along with the prescriber's information, signature, and NPI.
Many DME items require multiple HCPCS codes for billing purposes. Each of these items needs to be listed on the DWO along with the prescribed settings (if applicable).
We have two ways to help you complete a proper DWO:
- Our order form, when properly completed and signed, will serve as a Detailed Written Order.
- Our EMR system will create a DWO for you. All you need to do is verify the information, sign, and return it to us.
Mobility Related Activities of Daily Living - MRADL
- Toileting
- Bathing
- Feeding
- Grooming
- Dressing
Medicare will only cover a wheelchair when the patient's medical condition limits one of the five MRADLs - IN THE HOME.
A wheelchair will not be covered for activities outside of the house, even if they involve healthcare (going to doctor appointments, dialysis, etc.)
Coverage only occurs if the patient's medical condition impacts an MRADL while inside the home.
Note that once the MRADL hurdle has been met (in the home), the patient may use the equipment outside or for any other purpose.
The patient's medical record should clearly state the medical condition that is impacting mobility and that it is preventing or interfere with one of the MRADLs above.
A face to face examination is a medicare requirement for the coverage of medical equipment.
Very simply, a face to face exam occurs when the patient and physician are in the same room and an exam is being conducted. A key component of this type of exam is objective findings (blood pressure, temperature, objective observations, etc.)
During the COVID-19 public health emergency face to face rules have been relaxed for some items and now allow telemedicine reports.