Sept. 10, 2021

Durable medical equipment (DME) consists of items used to preserve bodily functions or to prevent disability or injury.  Like any other service, it is important that you verify eligibility and benefits prior to rendering services.  Doing so allows you to provide the patient with accurate cost-shares, authorization requirements, and service maximums that may apply.  Eligibility, benefits, and prior authorization can be obtained online through My Insurance Manager℠, which allows you to avoid calling into the customer service line.

Keep in mind that most DME is rent-to-own, which typically takes about 10 months.  However, there are certain items that must be purchased, such as customized orthotics.  No matter the option, it is important to clearly explain this information to your patients at the time of service.  Also, when submitting claims for DME, be sure to append the appropriate modifier to distinguish whether the equipment is being rented or purchased.

For more information, please be sure to review the Medicare Advantage resources available on www.SouthCarolinaBlues.com.  You can also contact Provider Education with any questions you may have using the Provider Education Contact Form located on the same website.