Due to a variety of reasons, long delays are not uncommon when trying to obtain or repair durable medical equipment (DME). We have a few tips for navigating and getting the most out of this flawed system.
“There’s no way to avoid the wait time, but there are ways to be effective while you’re in wait mode,” Leslie Lobel says.
To start, obtain the medical documentation required to initiate the DME acquisition process. Next, figure out how DME coverage works with your health plan.
It’s also important to ascertain if you will need prior authorization from your insurer before they agree to cover the cost of your kid’s equipment. Medi-Cal always requires prior authorization for DME (as primary or secondary coverage), and many private insurers do as well.
Throughout the process, make sure to do anything the DME provider asks of you in a timely fashion. Whenever you communicate with the DME provider, be sure to ask them to acknowledge your correspondence, and keep your tone as professional and courteous as possible.
Additionally, when a technician comes to fit your child, ask them lots of questions about the equipment in question.
For more tips, see our full article Durable Medical Equipment (DME) 101.
