DME provider definition

DME provider means those entities enrolled with DMAS to render DME services.
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DME provider means any provider enrolled with the Department as a Durable Medical Equipment provider.
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Examples of DME provider in a sentence

  • Coverage for some diabetic equipment and supplies may only be available from either a DME provider or from a pharmacy.

  • HNE covers items such as:• Automatic blood pressure monitors (Effective January 8, 2021, Prior Approval is not required when prescribed by a doctor and supplied by an In-Plan DME provider.

  • Such bundled agreements shall be reimbursed either monthly or in units per year based on the individual agreement between the DME provider and DMAS.

  • To enroll in the CSHCN Services Program, an orthotics and prosthetics provider must be actively enrolled in Texas Medicaid as a durable medical equipment (DME) provider or as a licensed prosthetist and/or orthotist, have a valid Provider Agreement with the CSHCN Services Program, have completed the CSHCN Services Program enrollment process by enrolling as an individual or as a group of performing providers, and comply with all applicable state laws and requirements.

  • A subsequent evaluation after the delivery of the custom manual and/or custom motorized/power wheelchair by a PT or OT, not employed by the DME provider or the manufacturer, to determine if the custom manual and/or custom motorized/power wheelchair is appropriate for the resident’s needs.

  • When requesting manually priced items, the DME provider must indicate the name of the product, the product number, and the name of the manufacturer or distributor and must provide the required documentation for pricing.

  • The broker shall not arrange NEMT services to a Durable Medical Equipment (DME) provider that provides free delivery or mail order services.

  • The Division of Medicaid does not allow the beneficiary to be billed if the DME provider chooses to deliver the item/service prior to submitting a prior authorization request and approval is not given.

  • Any other type of nonstandard DME requires prior authorization by the office and must be billed to Medicaid directly by the DME provider.

  • If the DME provider supplies a custom motorized/power wheelchair that is not covered under a warranty, the provider is responsible for any repairs, replacement or maintenance that may be required within two (2) years.

Related to DME provider

  • Provider is any individual or company that provides professional or technical services.

  • Participating provider means an Administrator Hospital or Professional Provider which has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to participants in the Participating Provider Option program or an Administrator facility which has been designated by the Claim Administrator as a Participating Provider.

  • Primary care provider means a participating provider who supervises, coordinates, or provides initial care or continuing care to a covered person, and who may be required by the health carrier to initiate a referral for specialty care and maintain supervision of health care services rendered to the covered person.

  • Private provider means any person who contracts with a governmental entity to provide services directly to the public.