Supplier standards
Medicare billing privileges depend on enrollment, accreditation unless exempt, and ongoing supplier standards, with each physical location enrolled separately. A lapse can stop payment regardless of how good the claims are.
DME claims are won before delivery
Durable medical equipment billing depends on paperwork that has to exist before the item leaves your warehouse: a valid order, any required face-to-face encounter or prior authorization, and proof the patient received it. Rentals then keep billing month after month.
Book a demoHow supplier billing differs
Most Medicare DMEPOS claims are filed by enrolled suppliers to the DME MACs, under rules a physician office rarely sees.
Orders, encounters, and authorization
Items on CMS's Master List may need a face-to-face encounter and written order before delivery, and some need prior authorization as a condition of payment. CMS updates those lists at least once a year.
Rentals and purchases
Some equipment is bought outright and some is rented monthly, with payment rules that depend on the item's category. Rental claims recur, so a missed month or a lapsed authorization can quietly drain revenue.
Separate intake, delivery, and claims
Intake staff gather orders and documentation, drivers or fitters confirm delivery, and billing turns it into claims. Each step needs a named owner.
What the supplier keeps
Enrollment, accreditation, inventory, delivery, and patient instructions stay with your team, along with collecting orders and proof of delivery.
What Taiga takes on
Taiga's billing team handles eligibility checks and claim submission and scrubbing, and works every denial and appeal, including small-dollar ones, plus patient statements.
Where a decision is needed
Prior authorization requests, refill and resupply confirmations, and chasing missing order details from prescribers need an owner before claims move.
Questions for a DME fit call
Bring a de-identified order, a delivered-and-paid claim, and a denial. Keep patient details out of the booking form.
What do you furnish?
List your categories, such as standard equipment, power mobility, orthotics, supplies, or oxygen, with rental versus purchase volume.
Who pays?
Break out Medicare, Medicare Advantage, Medicaid, and commercial plans, since each has its own authorization and documentation rules.
Where does the paperwork live?
Name the system that holds orders, delivery records, and authorizations, and how prescribers send documents.
For suppliers tired of chasing denials
Relevant to an independent DME supplier whose team spends more time reworking denied or stalled claims than serving patients.
Supplier claims need a fit check first
Taiga has not published support for DMEPOS supplier claims. This page does not handle enrollment, accreditation, or coverage decisions for any item.
Questions about dme suppliers billing
Does Taiga handle DME supplier billing?
DME suppliers are not on Taiga's published specialty list. Bring your item and payer mix, and Taiga will tell you straight whether it fits.
Do all DME claims go to the DME MAC?
Most Medicare DMEPOS claims from enrolled suppliers do. CMS notes exceptions, such as splints and casts furnished by physicians, which other contractors process.
Which items need prior authorization?
CMS keeps a Required Prior Authorization List drawn from its Master List of DMEPOS items and updates it periodically. Check the current list before delivery, since payment depends on it.
Can we move billing without changing our software?
Taiga works alongside a practice's existing EHR rather than replacing it. For a supplier system, confirm on the fit call how orders and delivery records would reach billing.
Bring your item and payer mix
Show Taiga what you furnish and who pays for it. You will get a straight answer on whether it fits.
System guides show possible billing handoffs, not proven specialty compatibility.