Best Credentialing Companies for Medical Equipment Providers

To join an insurance network, you must go through a complicated procedure called credentialing that needs a lot of paperwork and verification. A small mistake or missing form can make it take longer to sign up and cost you a lot of money because you won’t be able to see those networks’ patients. For your business to thrive, selling anything from wheelchairs and oxygen tools to home hospital beds, you will need to be signed up through Medicare and commercial insurance. If you select the wrong credentialing partner, your payment for the equipment you deliver may take as long as months to materialize. Learn about the best credentialing companies for Medical Equipment Providers (DME/HME), DMEPOS credentialing, and contracting with payers. We list the companies that know how to deal with the unique compliance issues that medical equipment sellers face. 

Why Is DME Credentialing Essential? 

When a durable medical equipment supplier lacks the required credentialing, this means that he/she cannot bill Medicare or the majority of insurance firms. The Centers of Medicare and Medicaid Services (CMS), through the DMEPOS program, strictly approves all DMEPOS facilities.  down, and the money will not come in. 

Payer-Specific Supplier Requirements 

Strict standards for Medicare credentialing separate real providers from fake ones. CMS requires all DME providers to meet quality standards before enrolling them. You have to show that your company keeps the right inventory, hires qualified workers, and follows the right transportation procedures.  

There are different requirements for medical equipment suppliers to join each business insurance network. Aetna, BCBS, UHC, and Cigna all have their own ways of verifying credentials. Some need more state licenses than what Medicare requires. 

Denial Risk for Non-Accredited Providers 

Your whole business plan is at risk because of the denial risk for non-credentialing providers. Insurance companies do not pay suppliers who lack proper qualifications, leading to patients sometimes paying for equipment that should be covered. Many new Home Medical Equipment (HME) providers struggle due to underestimating the credentialing process. Professional Durable Medical Equipment (DME) credentialing services can streamline applications by managing necessary paperwork, maintaining insurance relationships, and facilitating follow-ups, ultimately preventing costly mistakes and expediting payments. 

Required Credentialing for Medical Equipment Suppliers 

Knowing all the credentials that are needed helps you assess possible credentialing partners. Medical equipment suppliers need to get a lot of permissions before they can properly do business and get paid. 

DMEPOS Medicare Enrollment 

Signing up for DMEPOS Medicare is the first step in getting your credentials. To get Medicare funds, every DME provider has to sign up through the Provider Enrollment, Chain, and Ownership System (PECOS). The application needs detailed information about the business, such as who owns it, where it’s located, and any deals with suppliers. CMS looks at financial records and checks the backgrounds of all owners. When done right, DME Medicare registration usually takes 90 to 120 days. 

State Licensure 

Different places and types of tools have different state licensing requirements. In most states, HME providers need special licenses on top of their regular business registration. Some states require oxygen providers, prosthetic providers, and people who sell tools used in pharmacies to have their own licenses. A lot of the time, licensing boards want to see proof of liability insurance, surety bonds, and credentials for experienced staff. Not having the right state licenses can make it impossible for you to get Medicare. 

Payer Enrollment & Contracts 

Which patients you can help depend on payer enrollment and contracts with private insurance networks. Each insurance company has its own list of approved providers of durable medical equipment. The process includes sending in proof of business documentation, showing that you are credentialing, and negotiating reimbursement rates. Experts in HME billing and credentialing can get better contract terms because they know how much things cost in the market. 

Accreditation by ACHC or CHAP 

It shows patients and payers that the health care is of a high level. Health care workers are mostly credentialed by the Accreditation Commission for Health Care (ACHC) and the Community Health Accreditation Partner (CHAP). As part of the accreditation process, documents are looked over, sites are surveyed, and continuing compliance is checked. 

Annual Revalidation 

Revalidation once a year keeps your credentials up to date. Every five years, CMS makes all DMEPOS providers confirm that they are still in the program. But some changes mean that revalidation has to happen right away. When you move, change ownership, or add new types of tools, you need to make changes. Recredentialing is also done on a regular basis by commercial users. As part of the supplier onboarding process, you should get ongoing compliance help to keep your enrollments. 

Top Medical Equipment Credentialing Companies 

The following companies are considered the best credentialing companies for medical equipment providers (DME/HME). Each has its own strengths that can help with DME and HME registration problems. 

Credex Healthcare 

Credex Healthcare is the leading company in DME credentialing services, with specialized expertise in getting Medicare DMEPOS approval. Their team knows how to deal with the complicated rules that medical equipment sellers have to follow every day. They have successfully enrolled hundreds of DME providers across all equipment categories. 

Credex Healthcare is great at handling the whole credentialing process for equipment suppliers. They are in charge of the initial DMEPOS enrollment, coordinating state licenses, accreditation preparation, and commercial payer contracting. Their experts keep up with changes to CMS policy that affect companies that sell medical tools. 

Key Features

1. Quickly sign up for PECOS DME; usually done in 90-120 days or less. 

2. Help with the ACHC and CHAP accreditation steps. 

3. Know what all 50 states need in order to get a DME license. 

4. Good contract terms are guaranteed by strong relationships with big insurance networks. 

5. Prices are clear and do not include any hidden charges. 

6. Ongoing DME compliance help, including revalidation management. 

Ideal for new suppliers launching their business and established companies expanding into new markets or equipment categories. 

Transcure 

It provides full credentialing and billing services, which include enrolling DME suppliers. Their unified method combines managing credentials with managing the revenue cycle. Transcure is a good choice for suppliers who want credentialing and payment services in one package. They know how proper registration affects the process of filing claims and getting paid. 

Service packages that include both enrollment and continued billing help. Experience with a wide range of tools, and is a good choice for suppliers who don’t have their own billing teams. 

CureMD 

Along with their practice management platform, CureMD offers technology-based credentialing options. As part of their larger healthcare services, they work with medical equipment providers. 

Their platform lets you check on the state of credentials in real time. They have online portals for managing documents and getting updates on their state. Integration with billing tools makes things run smoothly. Good for bigger DME businesses that manage more than one site. 

nCred 

nCred is different from many RCM companies because they only do credential and provider enrollment. Because they are so focused on one thing, they are a great choice for groups that need experts who are only interested in this process. It is best for practices looking for a credentialing-only partner. 

Capline Healthcare Management 

Capline focuses on hospitals and multispecialty groups, handling credentialing, re-credentialing, and payer negotiations. Their experience with larger organizations helps speed up approval times. Hospitals and high-volume practices can get benefits from it. 

MedBillMD 

MedBillMD does medical billing and licensing; they focus on faster turnaround time. They work on registration projects with DME providers. Best for DME/HME needs, MedBillMD puts speed at the top of its authorization process. They ensure faster payment through their efficient and streamlined steps for applications. They know how to use popular DMEPOS categories. This is a good option for sellers who need to quickly sign up for Medicare. 

MedbillRCM 

MedbillRCM is an expert in managing the revenue cycle and offers combined credentialing services. They take care of the complicated paperwork that comes with becoming a seller. 

It is the best choice for DME/HME needs because it provides full support for sellers who want to outsource all administrative tasks. They offer a full range of services for bringing new suppliers on board, and can handle licenses, coordinating accreditation, and enrolling payers. They work well for sellers who have a small office staff. 

MedCareMSO 

MedCareMSO is a management services company that helps a wide range of healthcare companies, such as DME suppliers, with credentialing. It is best for DME/HME needs and provides full operating support, which includes credentialing as part of its larger business services. 

Their full method to practice management can manage many different parts of the DME processes. It is good for new sellers who need a lot of help with their business. 

Practolytics 

Medical bills and credentialing are both improved by Practolytics’ use of data analytics. They keep track of and report on the growth of credentials in great detail. Practolytics is best for DME/HME needs because it is transparent and gives suppliers thorough reports throughout the credentialing process. 

They have an analytics-driven approach to credentialing management and have a clear insight into the status of the application. It is good for DME companies with multiple locations that need to keep track of many enrollments. 

Verisys 

Numerous healthcare entities use Verisys to check the credentials of people who work for them. Aside from that, they also help sellers get credentials directly. Verisys is a trustworthy company because payers and accreditation groups use its services to check information. They have thorough checking methods that lower the chance of rejection for an application. It is best for suppliers with complicated pasts or one-of-a-kind scenarios. 

Final Verdicts: Choosing the Right Credentialing Company for DME Providers 

When choosing a credentialing partner, medical equipment companies need to think about a number of things that will have a big effect on their revenue and how well they run their business. It’s also important to know the rules for Medicare and DMEPOS; the credentialing partner should be able to show that they have successfully enrolled providers for Medicare Part B and handled claims quickly. To write down information correctly, you need to know the special rules for different types of equipment, such as wheelchairs and oxygen tanks. Turnaround times impact when services start and how much money is made; therefore, it’s important to know how long Medicare enrollment and other contracts will take. Furthermore, help for accreditation from well-known organizations like ACHC or CHAP is important for making sure that the process is followed and making it less stressful. 

Credex Healthcare is the best company that offers credentialing for your medical equipment services in all states. Our team has a lot of experience with DMEPOS. We keep our understanding of all changes to CMS policy up to date. With the right paperwork, we generally have a track record of faster turnaround time than others. 

 Are you ready to get quick credentialing for your medical equipment providers (DME/HME), the right credentialing? Contact Credex Healthcare today for a free consultation. We’ll look at your unique needs and come up with a personalized credentialing plan that gets you enrolled quickly and properly. 

FAQs 

What is DME credentialing? 

DME credentialing is the process of getting Medicare, Medicaid, and private insurance networks to accept providers of durable medical equipment. It includes signing up for DMEPOS Medicare, getting a license from the state, getting credentialing, and making deals with payers so that suppliers can get paid for the medical tools they give to patients. 

How long does DME Medicare enrollment take? 

It usually takes 90 to 120 days from the time an application is sent to the time it is approved for DME Medicare registration. The time frame relies on how accurate the application is, how busy the CMS is, and whether a site visit is needed. The process can take six months or longer if applications are incomplete or there are problems with compliance. 

What documents are needed for DMEPOS? 

You need business licenses, tax IDs, proof of ownership, proof of location, liability insurance, surety bonds, supplier standards attestation, and accreditation certificates in order to participate in DMEPOS. Depending on the equipment categories you have, you may also need staff credentials and proof of product inventory. 

Do DME suppliers need accreditation? 

Yes, Medicare requires all DMEPOS providers to keep their licenses from a recognized group like ACHC or CHAP. A lot of business insurance networks also need suppliers to be credentialed before they will work with them. Getting credentialing shows that you meet quality and safety standards.