Durable medical equipment (DME) refers to medical equipment meant for extended or everyday use. It assists patients in managing their everyday lives more easily when they’re dealing with illnesses and conditions. Durable medical equipment offers a variety of benefits, including support and stability, helping patients get closer to their recovery goals and regain functionality.
Insurance companies usually cover DME, with Medicare Part B covering medically necessary equipment that a physician prescribes for patient use at home. But what qualifies as durable medical equipment? Learn more about the role of DME in healthcare and eligibility.
Defining Durable Medical Equipment
Durable medical equipment is the term for medical supplies or equipment that healthcare providers prescribe to patients for home use. It has to provide therapeutic benefits and be necessary for recovery or in their daily lives.
Examples of Durable Medical Equipment
Durable medical equipment comes in many forms. Here is a look at some of the most common examples:
- Wheelchairs, Walkers, and Crutches: Help patients with mobility
- Hospital Beds: Help with patient positioning at home or aid patients who require special attachments, like traction equipment
- Oxygen Equipment and Respiratory Devices: Help patients breathe
- Blood Pressure Monitors: Monitor daily blood pressure in people who have hypo or hypertension
- Pressure Mattresses: Prevent pressure sores in bed-bound patients
- Home Dialysis Equipment: Help people who have kidney failure
- Prosthetics and Orthotics: Assist people who are missing limbs or who need special supports to walk
- CPAP Machines: Help people who have sleep apnea
- Glucose Monitors and Test Strips: Monitor daily blood sugar levels
There are many other types of durable medical equipment that assist patients in monitoring and maintaining their health at home. They are all important parts of healthcare.
How Durable Medical Equipment Supports Patient Care
DME provides significant benefits for patients dealing with long-term conditions or disabilities. Crucially, DME items help with patient mobility. Wheelchairs and scooters allow patients to move around independently. These devices enable them to continue their lives and participate socially, which is also a boost for mental health.
Items like orthotics, braces, and crutches are essential for patients going through the rehabilitative process after surgery. They can assist them in regaining functionality and aid them in their recovery.
Durable medical equipment like hospital beds, patient lifts, and bathroom aids allow patients who have mobility issues to stay safe as they go about their daily lives. Crucially, though, they also offer independence. Patients who have this equipment don’t have to rely on others as much, which is important for emotional and psychological well-being.
Patients who are living with chronic conditions like diabetes and respiratory conditions rely on DME as well. Those struggling with sleep apnea, COPD, and other conditions can benefit significantly from DME such as:
- Insulin pumps
- Glucose monitors
- CPAP machines
- Humidifiers
- Ventilators
Items like power wheelchairs don’t just help people with disabilities or long-term conditions. They also allow those recovering from surgeries and elderly patients to be able to live their lives safely and comfortably.
Importantly, these devices have an impact on caregivers, too. They reduce some of the burden of care, which can often be physically grueling. Hospital beds, for example, help with patient positioning so that family members don’t have to do this work entirely on their own.
Qualifying for Durable Medical Equipment
To be considered DME, an item must meet certain criteria. Each piece of equipment needs to:
- Be durable
- Be used at home
- Have a medical purpose
- Have an expected lifetime of three or more years
- Be useful for someone who’s sick or injured
The items have to be prescribed by a healthcare provider, and they must be reusable. Keep in mind, too, that some items are categorized as medical supplies rather than DME. Medical supplies are used once or only for a short period. In some instances, as when dealing with incontinence products, insurance may still cover medical supplies as part of DME.
Insurance Coverage for Durable Medical Equipment
Medicare Part B, as well as Medicare Advantage, will cover DME if a Medicare-enrolled healthcare provider deems a patient has a medical need for it. The type of item it is will dictate if the patient has to rent or buy it. Some items become the patient’s after they make a certain number of rental payments.
The costs in Original Medicare require that you meet the Medicare Part B deductible and then pay 20% of the Medicare-approved amount. Medicaid will cover durable medical equipment as part of its mandatory home health benefit. It’s important that you carefully look at your coverage, however, because some items, like prosthetics, are considered optional.
Private insurance may cover DME as well. However, patients must check the summary of benefits and coverage section of their policies to know what is and isn’t covered.
How In-Office Dispensing and DME Provision Benefits Patients
In-office dispensing allows patients to receive over-the-counter medications, prescription medications, and even DME directly from their doctors without needing to travel to another location. If a patient requires portable oxygen, for example, they could receive it there at the clinic when they go for their appointment.
For a start, this saves patients time and the need to travel to another location, which could be tough for those with mobility problems or unreliable transportation. However, it also means that there’s less need for third-party DME suppliers. That could result in more affordable supplies and a smoother overall process.
If patients can leave the office with everything they need, they’re more likely to start their treatment immediately instead of delaying it until they’re able to get to the pharmacy. As a result, there’s a chance for better patient compliance and patient outcomes.
This option also gives providers the chance to offer medication education. Often, patients hesitate to take newly prescribed medications because they’re not sure what they’re for or they fear side effects.
They may even be confused about their physician’s instructions on how to take the medication or use a certain device. In-office dispensing gives physicians the chance to fully explain and address any concerns the patient has. This, too, can result in better patient compliance.
Physician dispensing companies like Proficient Rx help integrate DME dispensing into healthcare practices with software that reliably allows physicians to manage inventory and order online quickly and easily. Our turnkey DME and medication dispensing services can improve patient care while also helping clinics increase their revenue.
FAQ
Do you have questions about durable medical equipment and how in-office dispensing works? The team at Proficient Rx has the answers.
What Is Considered Durable Medical Equipment (DME)?
Durable medical equipment refers to equipment and supplies that a medical provider orders for at-home patient use. To be considered DME, the item has to have a medical purpose, be durable, and help patients recover from conditions or assist them in their everyday lives. Examples include power-operated wheelchairs, nebulizers, canes, and hospital beds.
How Does Durable Medical Equipment Support Patient Care?
DME allows patients to maintain their independence by providing mobility and allowing them to manage medical conditions from the comfort of their own homes. DME helps improve a patient’s quality of life and aids in their recovery process. For those who have long-term conditions, DME offers the necessary support to perform everyday tasks.
Is Durable Medical Equipment Covered by Medicare?
Medicare Part B does cover some DME if it has been prescribed by a doctor for home use. Medicare doesn’t cover every type of DME, however, so the answer here could depend on your specific coverage and the item type.
Can Healthcare Providers Offer DME Directly to Patients?
Yes. Healthcare providers who offer physician dispensing services can provide DME directly to their patients. This option makes it easier for patients to get the items they need without having to travel to another location or wait to begin their treatment.
DME: Helping Patients Better Manage Their Health
Many patients depend on durable medical equipment for everything from moving safely to being able to breathe correctly. Without DME, they would not be able to live more independent lives and would have to rely on constant medical supervision, which most people can’t afford.
One of the ways that healthcare providers can further assist patients is by offering in-office dispensing. In-office dispensing is beneficial for everyone involved. Patients don’t have to travel to another location to get their prescriptions filled, which helps avoid potential treatment delays and patient non-compliance.
When patients get to fill their prescriptions at the office, their physicians can be beside them to answer any questions. Being able to provide this level of care puts patients at ease and motivates them to follow all treatment instructions. Ultimately, the result is better patient outcomes.
Contact Proficient Rx for Physician Dispensing Options
At Proficient Rx, we have years of experience helping healthcare providers introduce physician dispensing services to their practices. We’ll assist in their seamless integration so that you can start offering DME and medications right from your office. Contact Proficient Rx to learn more about how we can help with DME dispensing.