Your specialist works the queue you assign: intake and eligibility, collecting orders and records from referring providers, claim preparation, monthly rental billing, payment posting, denial follow-up and AR. Behind them we run sourcing, vetting, payroll, HIPAA-aligned infrastructure and replacements.
Why DME Claims Deny
Most of what a DME claim needs is created somewhere else. The order comes from a prescriber. The medical necessity support lives in that prescriber's notes. Proof of delivery comes from your own team or a courier. If any piece is missing or does not match, the claim is at risk, and a physician's office has its own priorities when you ask for a signature or a chart note.
Rentals raise the stakes. Many items bill every month, so a gap in the file at setup can repeat on every claim that follows.
What the Specialist Keeps in Order
Rentals, Month by Month
Many items bill as monthly rentals rather than a single purchase. Under Medicare, capped rental items stop after 13 continuous rental months (CMS Claims Processing Manual, ch. 20); commercial payers set their own terms. The specialist tracks each patient's cycle, including breaks and equipment swaps, so no billable month is missed and nothing bills after the cycle ends.
When a Document Is Missing
Most DME denials trace to a missing or mismatched document. The specialist finds the gap, gets the document and resubmits. True coverage denials get prepared for appeal with the complete file. Your team chooses the codes, you decide which appeals to pursue, and nothing is written off without your sign-off.
For a backlog of aged claims, see AR recovery and denial management.
Remote or On-Site
Billing specialists work remote from a managed, HIPAA-aligned environment. Where your company needs patient-access roles in the building, myMedCrew places on-site as well, scoped on brief.
What a DME Billing Specialist Costs
DME billing specialists sit in our RCM tier at $14/hr, billed on hours worked.
Proof Behind the Placement
How It Starts
Book a call and bring your main product lines and last month's denials. We scope the role against your order volume and payer mix, present pre-vetted candidates, and administrative placements are typically working within 15-20 business days. If a placement does not work out, we manage the transition and the replacement.
Verification support ahead of delivery lives at insurance verification and eligibility services; the generalist parent page is medical billing services. For home-based care alongside equipment, see home health billing.
Frequently asked questions
Why do DME claims get denied so often?+
Because payment depends on documents largely created outside the supplier: the order, medical necessity support in the prescriber's records, and proof of delivery. A missing or mismatched piece can deny the claim, and on rental items the same gap can repeat every month.
Does Medicare still require certificates of medical necessity?+
No. Medicare discontinued certificates of medical necessity and DME information forms for claims from 1 January 2023; the supporting information now comes from the claim and the medical record. Some other payers use their own forms, which the specialist tracks where they apply.
What is a standard written order?+
The order Medicare requires for DME, which replaced the detailed written order in 2020. It has to include specific elements, such as the beneficiary, the item and the order date, and the specialist checks each one before the item ships.
How are rental items billed?+
Many items bill monthly as rentals. Under Medicare, capped rental items pay for up to 13 continuous rental months; commercial payers set their own terms. The specialist tracks each patient's cycle so the right months bill.
Who decides on codes and appeals?+
Your company. Code selection stays with your team, appeal decisions and write-offs need your sign-off, and the specialist prepares each one with the complete file.
How much does a DME billing specialist cost?+
myMedCrew places DME billing specialists at a flat $14/hr, billed on hours worked.
How fast can the specialist start?+
For administrative roles, a placement is typically seated and working within 15-20 business days of the scoping call.
Show us where your paperwork stalls.
Bring last month's denials and we will map where a specialist would start.