Hi, we are neurosurgeons and do supply some DME. One is a bone stimulator. We are DME suppliers with Medicare and Medicaid. However, one insurance company is denying us stating that we are not DME suppliers. I am trying to find a law or anything to show that we can supply these items. Our contract does not state we can't... so I need to appeal this asap. Any help would be appreciated.
I have over 16 years experience in the DME industry. If you are enrolled with Medicare and Medicaid as a DME supplier, then I'm sure you know that your supplier number indicates that enrollment thru the National Supplier Clearinghouse, as it is a separate entity than that of a medical professional. With that being said, you must enroll separately with other insurance carriers as a DME supplier as well. Just because you are a participating provider for an insurance company, does not mean that you are enrolled as a DME supplier with the same company. It would most likely be a separate contract or an addendum to your professional provider contract but it would have to be specifically stated in your contract and not assumed a part of your professional contract. Best of luck.
You're more than welcome. I hope the information was helpful. I have needed help a few times and posted my questions but not once have I gotten a response. So, I try to help whenever I have the opportunity. Good luck.
Maybe we just don't have enough experts or enough time to answer. I will answer a question if I can, but who knows if I am right..LOL. I have been in this business for almost 20 years and I am still learning. Right now I work for Neurosurgeons.and they gave me a few hats to wear. Lots to learn. This is a good site for learning as well.