Purchasing durable medical equipment (DME) today is easier than ever before, thanks to technological advancements and new processes implemented by DME providers and insurance carriers. However, it may still be confusing for many patients, especially when it comes to figuring out their insurance coverage.
To make the process a little less daunting for your patients, use this guide to help them understand the factors to consider when purchasing durable medical equipment.
Does the DME suit the patient’s needs? What are its special features, if any? Is it safe and practical to use?
Asking these questions will help your patient decide if a particular type or model of DME is right for them. This, in turn, will ensure that they get the desired results, whether that’s getting around their home with ease or alleviating the symptoms of their illness.
Cost is one of the leading factors that influence a patient’s choice when buying DME. Encourage your patients to make price comparisons before settling on any one brand or model of the equipment they need. They should go with the most economical choice without compromising quality, durability, and effectiveness.
In addition, your patients should consider the total cost of ownership. For example, a patient diagnosed with obstructive sleep apnea is prescribed with a continuous positive airway pressure (CPAP) machine. Aside from the price of the CPAP machine and the required supplies and accessories (e.g., masks, tubes, pillows, etc.), the cost of maintenance, repairs, and replacements must also be carefully considered. Doing so will help the patient assess the long-term value of their purchase, as well as budget for the costs associated with CPAP therapy.
If your patient has health insurance, whether private, Medicare, or Medicaid, they should find out if the DME they need is covered. Even if it is, they should check if they have to pay for a percentage of the item’s total price, depending on their policy. To illustrate, Medicare beneficiaries are entitled to only 80 percent of the approved amount for the covered DME. If the approved amount is less than the actual price of the equipment, beneficiaries will shoulder the difference.
To avoid confusion when it’s time to pay, patients should review their insurance policy, or better yet, check with their carrier or DME supplier. It’s essential that they understand the details of their insurance policy and the amount they will be expected to pay.
Patients should also ask the supplier about the warranty of the DME they’re purchasing. In particular, they should find out if the DME is still under the original equipment manufacturer (OEM) warranty. An OEM warranty is a guarantee from the manufacturer that they will repair or replace any defective or damaged equipment or parts. It’s important to note that warranty coverages vary, so patients must compare the extent of warranty coverage, just as they would compare the price, model, and features of DME before purchasing.
Similarly, patients should ask about getting an extended warranty. Sometimes called a service agreement or service contract, an extended warranty covers repairs or replacements that occur after the OEM or standard warranty expires. Patients must keep in mind, however, that extended warranties cost extra, so they should carefully consider if getting one is really necessary.
DME provider’s credentials, background, and track record
To ensure that a patient’s insurance carrier will cover the cost of the DME, the patient must buy from an in-network supplier. Being in-network simply means that the DME supplier has been approved to bill the patient’s insurer. Purchasing from an out-of-network DME company means the patient will have to pay the full amount. Some health insurance providers offer coverage for out-of-network DME suppliers, but the patient would have to spend more out of pocket than if they’d purchased from an in-network supplier.
Also, when choosing a DME company to purchase from, the patient must ask the following questions:
- How long has the company been in operation?
- What areas do they serve?
- What products and services do they offer?
- How long will it take to deliver the DME?
Will someone help me assemble or install the DME, or teach me how to use or operate it?
It will also be helpful to learn what former and current patients have to say about the provider’s service, particularly how complaints are handled and how quickly they’re resolved. Patients can do this by reading reviews on the DME company’s website, social media, or platforms such as Google My Business, or they can ask for a list of references.
By carefully considering these factors, your patients will be able to pick out the best DME for their needs and enjoy an improved quality of life. And to help ensure that they get high-quality equipment, refer them to a DME supplier with a proven track record and a reputation for providing top-notch patient care.
If your patients need CPAP machines and supplies, for instance, get them in touch with Revsuppliance. We have been Oklahoma’s trusted provider of sleep apnea DME supply and billing solutions for over 10 years. Call 405-467-1791 today to schedule a demonstration and to learn more about our services.