Form (Durable Medical Equipment) Link

The "Form" link within the claim charges tab allows users to add a DME (Durable Medical Equipment) form to submit a DME Certificate of Medical Necessity (CMN) on claims.    

This field is tuned off by default. To see the DME Forms link option on a claim, the user-setting to "Show Durable Medical Equipment (DME) fields?" must be set to Yes. This setting can be found under Claim > Settings > Claim Settings for User.

Follow the steps below to add a DME Form on a Claim charge.  

  1. Select Claim > Claim.

  2. Use the Search field to search for your claim. 

    Check the “Show exact matches only” box to search for exact matches or “Show unpaid claims only” to show claims that may need follow-up.

  1. Open the claim.

  2. Click the Charges tab.

  3. Enter or find your procedure code (charge).

  4. Optional: Click the "Form" link to the right of the procedure code.

  5. Select the required DME form from the dropdown. 

  6. Fill out the form and add any required data. 

    If a payer requires you to report both the purchase price and the rental price on the same claim, fill out the rental fields (Rental Unit Price, DME Length of Necessity, Rental Total Price, and DME Frequency). The Total Rental Price is automatically calculated as Rental Unit Price × Length of Medical Necessity. For example, a Rental Unit Price of $50 (billed monthly) with a Length of Medical Necessity of 4 months results in a Total Rental Price of $200 (separate from the purchase price, which might be $500). 

    If you're only reporting the rental price for a piece of DME, you don't need to fill out these fields, simply enter the rental amount using the standard Unit Price, Units, and Total Charges fields, just as you would for any other charge.

  7. Click Apply.

  8. Click Save.