Improving DME Prior Authorization with a Decisive Guide

The CMS has always maintained a master list which may be subject to either one or both of the following prior to the delivery of a DME item:

• A written order and a face-to-face encounter
• Requirements with prior authorization

The master list of the entire DMEPOS items gets updated at least once every year. Recently the CMS announced in the federal registrar on 13th May 2024 the addition of 76 HCPCS codes and the removal of three HCPCS codes (E0565, A7025, L1833) which will be effective from 12th August 2024. Also, the prior authorization requirement list update will be including nine HCPCS codes.

The additional selections include osteogenesis stimulators, lumbar sacras orthoses and certain lower limb orthoses. As HCPCS code L1833 is removed from the master list, it has been removed from the required prior authorization list as well. From 8th August 2024, prior authorization for this code will not be required anymore!

All the above mentioned details are a testimony to the fact that working with the latest updates with DME prior authorization is not an easy task. You must find the perfect balance between knowledge and execution, and choose someone who can dive deep and engage better with your patients and payers with the right understanding of the latest DME prior authorization 2024 guidelines.

The Sunknowledge DME Prior Authorization Support

Our versatility, ability to dive deep, and our long experience in assisting some of the leading DMEPOS suppliers with our actionable support have made us into what we are today – a widely acknowledged giant in lending Prior Authorization support to DME prescribers and suppliers. We are currently working with some of the largest providers of the country and have been assisting them with our exclusive front end support system.

We have a skilled team that has the ideal understanding on how to work on DME prior authorization, initiating the PA request, checking of the eligibility details, following up with the doctor’s office, updating the DME prior authorization response in the PM system and so on. Know more about why we are hailed as a dynamic DME prior authorization services destination and how we help to set the ideal benchmark for a cleaner recovery of your claims later.

Speak to a DME prior auth expert at Sunknowledge and understand how we intend to drive your growth with our expertise. We know how to optimize your growth with our extended presence. Hire us as we have the right knowledge and expertise on how to accelerate your reimbursement process by laying down the desired checks at the front end with precision.