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Medicare Info

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Medicare Rules are Complex, Demanding, and Ever-changing

First, some basic info...

Before we go too far down the never-ending, always changing "Rabbit Hole"  known as Medicare, you should know that Diamond Medical Equipment LLC. is a local family-owned small business and a qualified and accredited supplier of Medicare’s Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. This means that when you are dealing with Diamond Medical, you are dealing with a qualified supplier who won Medicare's DMEPOS Competitive Bidding Program for Arizona - an arduous, demanding, and lengthy qualification process with no guaranteed outcome; a feat that we are very proud and honored with. It's something we take very seriously as it enables us to achieve our mission to help others when they need it most.

Medicare Basics

Medicare has several different plans, parts, and sections. Each of those have very specific coverages, varying rules, qualifications, and uses. While it is very important for you to know and understand the plans that are significant to you and your needs, it is simply beyond the scope of this site to detail all of this. Specific information is readily available and best handled elsewhere. We suggest you go straight to the source, Medicare.gov  for general and detailed information regarding specific plans. 

Diamond Medical Equipment can help guide you through the requirements necessary for you to qualify for Durable Medical Equipment benefits

It is our goal to supply you with the information you need in order to qualify for Durable Medical Equipment benefits through Medicare Part B.

Do You Qualify?

Click on the links below to learn about some of the specific policies and requirements:

Home Oxygen

Wheelchair

Semi Electric Hospital Bed

Low Air Loss Mattress

CPAP

Local Coverage Determination (LCD)

Active LCDs - Noridian  The active LCDs are provided with the title, contractor ID, applicable CPT codes and hyperlinks to the complete policy available on the CMS website.

Medicare Documentation Overview

ACA: Face-to-Face and Detailed Written Order - Noridian  Effective July 1, 2013, the Affordable Care Act (ACA) implemented face-to-face (F2F) and detailed written order (DWO) requirements for certain Durable Medical Equipment (DME) items. Please visit the new consolidated page to review all of the latest information.

Competitive Bidding

CBIC - Home  The DMEPOS Competitive Bidding Program was mandated by Congress through the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). The statute requires that Medicare replace the current fee schedule payment methodology for selected Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) items with a competitive bid process.

Medicare Supplier Standards

National Supplier Clearinghouse - Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Supplier Standards - Palmetto GBA  An abbreviated version of the supplier standards every Medicare DMEPOS supplier must meet in order to obtain and retain billing privileges.

Advanced Beneficiary Notice

If medicare denial is in question, it’s a standard notice to the beneficiary prior to providing the dme. This notice is called an Advance Beneficiary Notice of Non-Coverage or “ABN.” It lets the patient decide prior to, or would accept financial responsibility for the item or service, if Medicare does not pay.

The ABN is required in order to bill the patient or his/her co-insurance if Medicare denies coverage. It also serves as proof that the patient knew PRIOR to receiving the item or service that Medicare might not pay.