Enrollment in DME

This issue is only one which keeps coming up with respect to DME re enrollment or initial enrollment. There is a loophole in the forty hour minimal requirement for DMEPOS providers in that physicans do not have to meet that requirement. Furthermore they do not need to list actual hours. The enrollment agencies realize that physicians work not only in their offices, but in hospitals, nursing homes and some even still make house calls, to list but a few. Hence physicians (DPM MD DO) are not compelled to list hours nor meet the forty hour requirement.

This loophole also avoids mathematical mistakes on the application where the sum total simply does match up with the actual hours you list. Currently one provider had their application held up for months for this absurd reason. The advice given to them was to modify their applicaiton and remove the actual hours and change it to by appointment. The number of hours listed is as you see fit.

Let's not leave out the issue of the inspection. Inspectors can show up unannounced during any time listed on your actual hours on the application. If you are not there, you risk failing the inspection and potentially losing your ability to be paid for DMEPOS.

If instead you choose the By Appointment option, they must call in advance to inquire on your availability over the next few days or weeks. You can provide them with a day and time and they have to come during time frame.

There are many other loopholes which are advantageous to physicians. The advice to take from this posting is to seek out an expert who completes these applications daily. Your biller may be good at billing, but these applications are now built to entangle you in a web from which you may not ever escape.