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DME INITIAL PRECERTIFICATION FORM

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The document is a DME Initial Precertification Form used to collect necessary information for the precertification of durable medical equipment (DME). It includes sections for member information, diagnosis details, requested equipment, and vendor information. The form emphasizes the importance of providing complete information to avoid processing delays and clarifies that precertification does not guarantee payment.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (45 Votes)
2018	4.4 Satisfied (242 Votes)
2015	4.2 Satisfied (70 Votes)
2014	4.4 Satisfied (286 Votes)

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