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Click ‘Get Form’ to open it in the editor.
Begin by entering the patient’s name and social security number in the designated fields. Ensure accuracy for proper identification.
Select the shipping address option by checking either 'Home' or 'Facility/Clinic'. Fill in the complete address details including city, state, and zip code.
In the 'Home Medical Equipment' section, check all applicable items needed. Specify any additional equipment under 'Other'.
Complete the insurance information by providing the insurance company name, ID number, and group number. Attach a copy of your insurance card if necessary.
Ensure that the physician's signature is included at the bottom of the form along with the date. This is crucial for processing your request.
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Equipment and supplies ordered by a health care provider for everyday or extended use. Coverage for DME may include: oxygen equipment, wheelchairs, crutches or blood testing strips for diabetics.
What does DME mean with Medicare?
Durable medical equipment (DME) is equipment that helps you complete your daily activities. It includes a variety of items, such as walkers, wheelchairs, and oxygen tanks. Medicare usually covers DME if the equipment: Is durable, meaning it is able to withstand repeated use.
What is the difference between DME and medical supplies?
What is the difference between durable medical equipment and medical supplies? DME includes items that can be used for a long time. Medical supplies are disposable and usually used once or short term. Often these items are included in DME and may be considered DME by your insurance plan.
What does DME mean in physical therapy?
Durable Medical Equipment. (DME) Your mother is being discharged from the hospital after a serious fall. She cannot walk without assistance. Will she need a wheelchair at home?
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