Essential Elements of a DME Order Form

Durable medical equipment, or DME, refers to any medical device that’s used to aid people with disabilities, chronic health conditions, and acute injuries. Many types of DME require a prescription from a qualified healthcare provider that must be documented on a DME order form. Not only does this documentation help facilities comply with state and federal guidelines, but it also maintains a record of each patient's care needs.

At Qualis, we’re more than a middleman between hospices and vendors. Our job is to manage DME vendor operations, so you can focus on what you do best, providing the best possible care to your patients. Filling out this form is the first step in connecting patients with mobility aids, prosthetics, and other devices that support their day-to-day lives. Instead of looking at it as a simple order form, consider it an important communication tool.

Why Order Forms Matter

Billing Accuracy

By clearly demonstrating the reasons a patient might need DME and what types are needed, DME order forms can minimize duplicate charges and unnecessary spending. This can contribute to financial transparency and ensure accurate billing.

Equipment Delivery Timelines

Unlike regular medical billing, DME billing requires more up-front documentation before equipment can be delivered. Order forms that are filled out incorrectly or fail to demonstrate a patient's need can result in unnecessary delays.

CMS Documentation Audits

In the U.S., the Centers for Medicare and Medicaid Services oversee healthcare providers, hospices, and long-term care facilities. Audits play a major role in CMS oversight, so it’s important to keep a record of all compliant DME paperwork. Providing accurate financial and patient care documentation makes the auditing process more efficient, saving time and money.

Must-Have Sections on a DME Order Form

Patient Identifiers

Patient identifiers are crucial for matching each order to the correct address and for insurance claims processing. They can include information such as the patient’s full name, date of birth, and insurance ID numbers.

Diagnosis and ICD-10 Coding

Order forms should contain the correct ICD-10 code, which must be supported by an official diagnosis and a physician-ordered prescription in the patient’s medical history. Inaccurate codes or codes that aren’t supported by the right documentation may be denied by insurance. If this happens, you would have to resubmit the order, causing further delays.

Physician Signature/Date

A physician’s signature, accompanied by the date, certifies that the DME is medically necessary. Handwritten physician signatures for DME must be clear and legible.

Start of Care Date

The start of care date is the first date that the equipment will be initiated. This information is necessary for clarity, Medicare DME documentation, and billing accuracy purposes.

Detailed Item Specifications

This may include details like a specific brand or model number, measurements, accessories or auxiliary equipment, or the quantity needed.

Common Errors and How to Avoid Them

Missing Authorization

Some types of equipment require prior insurance authorization before they can be delivered to the patient. In most cases, orders that are missing the necessary preauthorization are denied. To avoid this, always check the authorization status before finalizing an order.

Unclear Medical Necessity Statements

To comply with Medicare and insurance regulations, the patient’s medical need for DME must be clearly stated in their documents. Incomplete, inaccurate, or unclear medical necessity statements can result in denied claims or delays in order processing. This can be avoided by double-checking that the order form is filled out correctly and collaborating with the ordering physician to ensure that the patient’s needs are communicated clearly and accurately.

How Digital Platforms Improve Accuracy

Qualis uses a single-platform interface so you can place orders, track deliveries, and generate reports, all from a single dashboard. With online file storage and centralized reporting, using a digital platform streamlines the flow of information, ultimately improving accuracy.

Interfacing with EMRs

Timely access to electronic medical records is important for patient safety and helps maintain efficiency for administrative tasks. A seamless interface with EMR-integrated order forms is included as part of Qualis’ business management services. This allows the business to run efficiently while providing real-time patient statuses, and it’s also why Qualis is the preferred DME management partner in the hospice care field.

Training and Review

The landscape of hospice and long-term care is always changing, so it’s important for clinical staff to review current industry standards. DME-specific CM (case management) or CME (continuing medical education) courses are invaluable for keeping staff up-to-date. For more information, check out Qualis’ resource library of whitepapers and eBooks, and explore testimonials to discover how we can make a difference in your business.

At Qualis, our partnerships with a robust DME vendor network mean you have access to your DME and customer service support. Need help refining your DME requisition forms for speed and compliance? Qualis can audit and improve your process. To learn more about Qualis, product demos, or our vendor network, contact us to speak with one of our experts.