DME Growth Support

Respiratory and sleep (including CPAP), mobility, orthotics and prosthetics, wound care, incontinence, and more. If you supply it, we can support the back office behind it.

Yes. We can scope our work to the parts of the DME revenue cycle where you need help, whether that is capped-rental tracking, CPAP and PAP resupply documentation, recurring rental cycles, or modifier accuracy, while your in-house team keeps the rest. We work as an extension of your office, so the split is defined during scoping based on where your denials and backlog actually sit.

We build the standard written order and proof-of-delivery requirements into the workflow before a claim goes out, checking that the SWO carries the required elements and that POD is on file for the date of service. Where documentation is incomplete, we flag it back to your team or the ordering provider rather than billing on a record that will be denied. Medical-necessity and LCD/NCD alignment is checked as part of that same pre-bill review.

The documentation and coverage rules genuinely differ by category, so the work is not interchangeable. For PAP and respiratory that means capped-rental sequencing and resupply eligibility and usage documentation; for mobility it means the face-to-face and HCPCS specifics tied to medical necessity; and for orthotics and prosthetics it means the order and delivery documentation those items require. We align each category to its applicable LCD or NCD instead of running every claim through the same checklist.

You do not switch. We work inside your existing EHR, PM, or DME billing platform as an extension of your office, so your data, workflows, and reporting stay where they are. During onboarding we get scoped access to the system you already run and adapt to your setup rather than asking you to adopt ours.

Onboarding starts with a scoping conversation about your categories, volume, payers, and current pain points, followed by secure access provisioning, documentation of your workflows, and a review of your open AR and denial patterns. Timelines depend on the number of categories, payers, and the state of your current documentation, so we set expectations during scoping rather than quoting a fixed number that may not fit your situation. The goal is a clean handoff with no gap in claim submission.

Yes, we operate under a Business Associate Agreement and handle PHI only inside your secured systems under HIPAA. We do not collect or store patient health information through web forms or marketing channels, and access is scoped to the staff working your account. Specific safeguards are confirmed in writing as part of contracting.

Pricing is scoped on a consult because DME cost depends heavily on your category mix, claim volume, payer set, and which parts of the cycle you want us to run. A high-volume CPAP resupply operation and a small O&P supplier have very different work profiles, so a single public number would be misleading. After a short scoping conversation we put a clear, specialty-specific proposal in front of you.

You get regular reporting on the metrics that matter for DME, including denial reasons mapped to CARC and RARC codes, clean claim rate, AR aging, and capped-rental and resupply status, so you can see where revenue is being won or lost. Because we work inside your own system, your team can also see the same claim-level activity in real time. We review the recurring denial patterns with you so fixes happen upstream, not just on appeal.