Durable medical equipment opportunities for DCs

BY MATT GRUSKIN, MBA, BOCO, BOCPD, CDME

Are you losing revenue by referring your patients to other businesses for the durable medical equipment (DME) in your patient care plans?

As a DC, you likely have patients who could benefit from DME products, such as:

• Custom fit braces (product code OR02)
• Off the shelf braces (product code OR03)
• TENS units (product code DM22)
• CPM devices (product code DM03)
• Traction equipment (product code DM21)
• Neurostimulators (product code PD04)

There is a significant opportunity to expand the services your practice offers while enhancing your reputation by providing comprehensive patient care. Credentialing your practice may enhance your revenue, as you can provide DME to your chiropractic patients instead of referring it to other providers. This puts the revenue in your own pocket and it all begins with accreditation and orthotic fitter certification (COF) from the Board of Certification/Accreditation (BOC).

Accredit your business

As a Centers for Medicare and Medicaid Services (CMS)-deemed accrediting organization (AO), BOC accredits businesses that provide durable medical equipment, allowing them to bill third-party payers, including CMS. Accreditation is good for your business and your patients. DME accreditation enables a practice to demonstrate it is adhering to CMS regulatory requirements. Earning accreditation is required before a DC can receive reimbursements from Medicare and other insurance carriers, including third-party payers, so it also positively impacts your ability to earn revenue. Additionally, it assures your patients of the competence, professionalism and safe practice environment of your business.

If you are not already accredited, review the CMS DMEPOS Supplier Standards and CMS DMEPOS Quality Standards. When you’re ready, there are five simple steps to follow to become accredited.

1. Submit your application. For your convenience, you can apply online or download an application.
2. Prepare for and participate in a site survey. BOC will review your application to determine site survey readiness. You are encouraged to use the Site Survey Checklist to prepare. A site surveyor will visit your business during the hours specified on your application. They will inspect your business location, required manuals, patient charts and financial documents.
3. Receive your results. BOC will notify you of your accreditation status after reviewing your site survey results. If your business does not meet the requirements, we will contact you for additional information and/or recommendations for improvement.
4. Submit any requested documents. Your survey results may include requests for additional documents that must be submitted before accreditation can be awarded. This is not uncommon, and BOC will answer any questions you may have.
5. Accreditation is awarded. You need to enroll with any insurance providers with whom you intend to participate. This may include applying for provider transaction number (PTAN), which is required to bill CMS. To obtain a PTAN, submit a Medicare enrollment application with a copy of your accreditation certificate to either National Provider East (Novitas Solutions) or National Provider West (Palmetto GBA), depending on your location.

Successfully earning accreditation from a CMS-deemed AO ultimately ensures your business is prepared to deliver DME supplies and drive positive health outcomes for patients.

Employ a certified orthotic fitter

If you want to offer your patients additional support by providing custom-fit braces, hiring a certified orthotic fitter (COF) or obtaining your COF credential can add value to your practice. COFs are qualified to supervise the selection of appropriate devices and measure, assemble and apply orthoses. Including a COF on your staff validates your practice provides expert care when custom-fitting orthotic devices.

The requirements to become a COF include but are not limited to successful completion (within the last five years) of an entry-level course through a fitter education provider and documentation of supervised patient care experience. Once a DC or team member meets the prerequisites, the next step is to take and pass a COF exam. BOC is the only AO whose exam is nationally accredited.

There are three steps to certification:

1. Submit your application. You can apply online or download the orthotic fitter certification application.
2. Schedule and take your certification exam. BOC’s test delivery provider, PSI, offers two test delivery options, in-person exams at a test center and live, remote online-proctored exams from your computer. Once your application is approved, you’ll receive notification of your eligibility to sign up for your exam. BOC offers year-round testing for all computer-based exams, which means you don’t have to wait for a testing window.
3. Receive your results. No matter what test mode you choose, you will receive your results instantly upon the completion of your exam.

Final thoughts on durable medical equipment certification

Because the DME field is dynamic and evolving, ongoing learning is essential to keeping up with the latest technology and process improvements in the profession. After earning the certification, COF professionals must meet continuing education requirements and renew the certification annually. BOC streamlines the process of meeting these requirements by listing learning opportunities online and providing a personal web portal to track continuing education units and deadlines.

Patients will need a prescription for a custom fit brace, and DCs can work directly with referring physicians, physician assistants or nurse practitioners. BOC or a consultant will guide DCs to additional resources about the documentation required to bill CMS, as well as your state’s guidelines.

By earning durable medical equipment accreditation for your practice and enlisting a certified orthotic fitter, you can provide the full spectrum of specialized patient care. The investment can benefit your practice and your patient community for years to come. For practices interested in pursuing the COF, BOC will waive the 1,000 clinical hours requirement for DCs and chiropractic clinical staff who apply for the COF professional credential. Use promo code “CHIRO” on your application.

MATT GRUSKIN, MBA, BOCO, BOCPD, CDME, is COO for BOC. He is responsible for leading the direction, strategy, policies and day-to-day operations of BOC’s accreditation and certification programs. Gruskin is focused on the growth of the credentialing programs and ensuring the delivery of excellent customer service. He holds an MBA in healthcare from Florida International University, a graduate degree in O&P from University of Hartford and postgraduate certification from the International School of Pedorthics.

About The Board of Certification (BOC)

BOC is an independent, not-for-profit organization that helps applicants every step of the way and provides an easy-to-understand accreditation and certification process. With nationally acclaimed, award-winning customer service and 40 years of credentialing experience, BOC is a respected and trusted resource. To learn more, visit bocusa.org/chiropractor-opportunities.