DME compliance is a necessity. When you consider the complexity of the billing process for Medicare, Medicaid, and Tricare beneficiaries—who make up the majority of patients who need DME–it makes hiring the right people even more crucial.

What does your current hiring process for DME compliance look like? Should you hire a full-time DME compliance officer, or is there a better solution? Are DME consultants/managed services more cost-effective? Is it worth it to outsource your DME compliance needs?

Get all your DME compliance hiring questions answered here.

Important Things to Know About DME Compliance

The Department of Health and Human Services’ Office of Inspector General (HHS-OIG) and the Centers for Medicare and Medicaid Services (CMS) are the major federal overseers of DME compliance. The most common violations are caused by billing errors, incompliant marketing practices, and the payment of illegal kickbacks or referral fees.

To guide DME suppliers towards compliance (and away from monetary and legal consequences), the HHS-OIG has provided a list of seven necessary elements for an effective DME compliance program:

  1. Implement written policies, procedures, and standards of conduct to all parties involved in the DME ordering, supplying, and delivery chain.
  2. Designate a compliance officer and compliance committee to ensure company-wide compliance.
  3. Conduct effective training and retraining among employees to demonstrate your commitment to keeping compliance at the forefront of business activity.
  4. Maintain open and effective lines of communication by making the DME compliance officer available to anyone who has a DME compliance concern (and allowing employees to report concerns anonymously.)
  5. Enforce well-publicized disciplinary consequences of failing to meet DME compliance standards.
  6. Conduct internal monitoring and auditing to identify compliance risks throughout the company.
  7. Promptly investigate and respond to DME compliance violations, then develop a plan of action to remedy the violation.

In essence, these seven elements offer a loose framework for what your practice needs to do to become a compliant DME supplier. Having a dedicated DME employee or team behind you also shows your commitment to mitigating fraud if and when you get audited by federal overseers.

DME Compliance Job Responsibilities

Most practices don’t hire a specific DME compliance employee and split the workload amongst their existing staff instead. This leaves the compliance officer no choice but to add DME compliance to their already large workload.  

DME compliance entails many responsibilities, including but not limited to:

  • Reviewing and validating referrals for appropriateness and completeness
  • Ensuring that patients are eligible for DME supplies
  • Procuring DME supplies and services according to established purchasing standards
  • Coordinating DME equipment delivery between vendor, physician, and/or patients
  • Reviewing medical billing and coding in DME system for any discrepancies and resolve any apparent issues
  • Ensuring that everyone involved in the DME supply chain are acting in accordance to ethical business standards
  • Developing and distributing DME compliance materials to other employees
  • Researching DME practices and updating the DME system/process to reflect updates in legal guidelines

Delegating DME compliance to your busy staff leaves your practice vulnerable to violations with monetary and legal penalties.

Hiring and Training DME Employees

Some entry-level medical equipment managers may require DME system and coding training, as well as education concerning Medicare practices. Most medical equipment managers are also expected to have prior healthcare and/or management experience. DME directors, on the other hand, will already have experience with DME systems and with coordinating large-scale DME compliance training and audits. But naturally, with more experience comes higher salary expectations.

On average, full-time medical equipment managers are paid an annual salary of $52,073, with more experienced DME directors making an average of $131,694 per year. This does not include medical or dental insurance, paid time off, 401(k) offerings, and any other benefits that are available to most full-time administrative employees in the health sector.

Your practice may only need one trained DME professional to protect against increased federal scrutiny and mitigate legal risks. However, if you assist in operating a large-scale practice or a hospital setting, you will likely require a team of DME compliance officers, with a DME manager to train everyone on the team.

Utilizing a Consultant

Hiring DME consultants is another option that can help medical practices gain accreditation as DME suppliers, develop and improve DME systems, and teach current employees how to follow the guidelines outlined by CMS. 

However, DME consultants only show employees how to follow compliance standards. It still falls on current employees to scour through existing medical files for billing and coding issues, find and procure DME supplies and maintain inventory, communicate with everyone involved in the supply chain, and continually assess patients’ needs for their current equipment.

And there’s always the chance that trained staff members who manage your entire DME system will move on in their careers, leaving your practice vulnerable. But what if you could outsource the entire DME supply and billing process to DME experts that sit onsite in your practice? 

Outsourcing to DME Experts

Outsourcing some or all of your medical equipment ordering, billing, insurance authorization, and compliance reporting needs to a service specifically staffed by DME experts, is the fastest, most cost-effective way to hire the right people for DME compliance.

Then, you can focus less on worrying about compliance and more on what matters most—seeing patients.

Find the Right Partner

The right DME experts to meet your practice’s needs should:

  • Have an understanding of retail-grade supply chain management
  • Provide a comprehensive multi-vendor product mix 
  • Scale resources according to your needs
  • Have a proven track record when it comes to passing DME compliance audits
  • Use an easy-to-navigate software solution that addresses every part of the DME procurement and delivery process
  • Be able to assess  your existing DME systems for areas of improvement
  • Show you how they are impacting your profit margins

Select Ortho’s DME compliance experts audit existing DME practices and optimize them so that our clients achieve over 95% net collection rates. Our team has over 10 years of combined experience in compliance which has enabled our clients to have 100% pass rates on payer audits and reviews.

In addition to DME compliance solutions, our clients also have access to proprietary software that optimizes their inventory, revenue, insurance authorizations, compliance requirements, payment tracking, and more.

No matter how large or small your practice is, no matter how well-developed your current solution is, Select Ortho will ease any and all DME compliance burdens so you can worry less about getting paid, and more about working with your patients.

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