Your Guide to Medicare's Durable Medical Equipment, Prosthetics, Orthotics, & Supplies DMEPOS Competitive Bidding Program
                     YOUR GUIDE TO MEDICARE'S 
DURABLE MEDICAL EQUIPMENT, 
PROSTHETICS, ORTHOTICS, & 
SUPPLIES DMEPOS 
COMPETITIVE BIDDING 
PROGRAM
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1. LACK OF UNDERSTANDING OF THE 
MANAGED CARE CONTRACT 
The Competitive Bidding Program by Medicare was launched to improve 
the overall value of Medicare and the money of the taxpayers used in the 
facilities. The program sets prices through competition, ensuring that the 
patients' items are of quality and licensed. It also allows only accredited 
suppliers to bid who must meet the standards set by Medicare. The 
overall process helps in reducing fraud and abuse of the Medicare 
system. 
What Is DMEPOS Competitive Bidding Program?
Congress mandated the DMEPOS Competitive Bidding Program 
in 2003 through 
Medicare Prescription Drug, Improvement, and Moderniz
ation Act (MMA)
. The Act required Medicare to replace its then methodology of 
fee schedule payment for selected Durable Medical Equipment, 
Prosthetics, Orthotics, and Supplies (DMEPOS) items with a 
competitive bidding process. 
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WHAT HAPPENS IF A PATIENT 
REQUIRES AN ITEM OF A SPECIFIC 
BRAND?
If a patient needs DMEPOS items not mentioned in the competitive 
bidding program, then the doctor must prescribe the brand in writing. It is 
only accepted when it can be established that there can be an adverse 
medical outcome without using the specific brand. In the document, the 
doctor must record why the brand is needed and how it can avoid a 
negative outcome. The contractor in such a situation is then required to:
Give the patient the specific brand of an item. 
If the supplier doesn't have or cannot get it for the patient, then they 
must help in finding another contractor who can provide it. 
Work with the doctor to find an alternative and then get the prescription 
revised.
Know more..
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 4.NON-HIPAA CARRIERS
HOW TO GET THE ITEM REPAIRED OR 
REPLACED? 
When a patient owns a competitively bid DMEPOS item and 
needs to repair or replace the parts, they can contact any 
Medicare-enrolled supplier. Even a non-contract supplier can 
help repair and replace the parts. But the supplier must be 
Medicare enrolled so the patient can get the reimbursement for 
the repaired or replaced parts from Medicare. However, 
Medicare will not pay for any replacement or repair covered by 
the warranty of the item's supplier. 
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  CAN THE DMEPOS ITEM BE 
RECEIVED FROM DOCTOR OR 
HOSPITAL?
Typically you should get the item from a contract supplier 
registered with Medicare. However, there are exceptions like:
The doctor or the treatment facility gives the equipment as part 
of the clinical service during the treatment despite not being a 
contract supplier. 
The doctor or the hospital gives the item when the patient is 
admitted or on the day of release from the hospital. It can be 
done even when the provider is not a contract supplier.  
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HOW TO ENSURE YOUR FACILITY IS 
BENEFITTING FROM THE DMEPOS 
COMPETITIVE BIDDING? 
If you are into Durable Equipment facility service and Medicare 
contracted supplier, then all these new rules can be confusing. In such a 
scenario, the best way to navigate the system is to get help from an 
outsourcing medical and billing partner such as 24/7 Medical Billing 
Services to ensure your revenue management is in place. It even won’t 
be the last thing to run into losses due to claim rejections as a Durable 
Equipment provider. 
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ABOUT US
We are a medical billing company that offers ‘
24/7 Medical Billing Services’ and support physicians, hospitals, 
medical institutions and group practices with our end to end medical 
billing solutions. We help you earn more revenue with our quick and 
affordable services. Our customized Revenue Cycle Management 
(RCM) solutions allow physicians to attract additional revenue and 
reduce administrative burden or losses.
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CONTACT US
Media Contact:
24/7 Medical Billing Services
Georgia
3001 Greenfield Drive, Marietta GA
 
Ohio
28405 Osborn Road, Cleveland, OH 4414030068
Texas
2028 E Ben White Blvd, #240-1030 Austin TX, 78741
Delaware
16192 Coastal Highway, Lewes, Delaware 19958, United States
Phone no / Fax :  +1 888-502-0537
                          Email us: [email protected]
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