Requirements for billing Medicare and Medicaid.

by John


I've been a inside sales rep for a one of the largest DME providers in the US for the last 2 years. In my position we cover everything from gathering the patient info, verifying ins., scripts...etc. I've personally only worked with private ins. companies, work comp, auto ins. and cash to take care of billing on the DME we sell. Can you give me some insight into what is needed for a company to be legally qualified or registered to bill Medicare and Medicaid claims for such patients. I'm looking at starting my own medical billing co.

PS. I've read your sections on Medicare and Medicaid and don't seem to see anything on having to register with the CMS.

Thanks for the insight!



I'm not well versed on DME billing but here are some resources on DME Accreditation that may be helpful:

Here's the Centers for Medicaid and Medicare press release on Accreditation for DME Suppliers.

Also the website EZDME has some good information and links on DME Accreditation. EZDME provides DME claims processing.

Hope these help - good luck in starting your DME billing service. Sounds like you certainly have the knowledge, experience, and connections to make it a success.



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