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Navigating DME coverage in 2023

January 24, 2023
Business Affairs

Know what to expect from DME providers
DME providers are incentivized to meet patients where they are at. They should be vocalizing to their health plan partners the barriers, obstacles and constraints that patients experience. Oftentimes, they engage with more patients per plan than most other provider types but are greatly underutilized.

A patient should expect for a DME provider to be the insurance coverage expert. They should work tirelessly to assist the patient with obtaining necessary equipment that includes coordinating with physicians and health plans to collect necessary paperwork and approvals. The DME supplier should also provide culturally competent care and ensure the patient understands the benefits of the equipment and supplies. This should be evident by the patient’s continued usage of the equipment.

A health plan should expect the DME provider to forge direct relationships with the patients. They should educate them on the policies and health plan expectations so that the culture of the health plan is embedded in the interaction with the health plan.

Ultimately, navigating DME coverage in 2023 is going to be difficult. It will take collaboration among all of the stakeholders to make it successful. We ought to spend time ensuring that our map for our shared members is clear to avoid any headaches or accidents.

About the author: Ryan Bullock is the COO at Aeroflow Healthcare.

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