Durable Medical Equipment (DME) Billing & Credentialing Services

Your DME Revenue Partner: Precision, Compliance & Payment Acceleration

Navigating the Durable Medical Equipment (DME) billing and credentialing landscape is anything but simple. It involves more than submitting claims—it requires deep knowledge of HCPCS Level II coding, Medicare DMEPOS supplier rules, detailed compliance documentation, and payer-specific protocols that vary by state and product type.

At Oakview Medical Billing Solutions, we specialize in helping DME suppliers of all sizes—from startup vendors to enterprise-level operations—maximize collections, reduce denials, and stay fully compliant. Our dedicated DME billing and credentialing teams understand the regulatory complexity and reimbursement dynamics that govern the industry—and we bring the firepower to simplify it all for you.

What Makes DME Billing So Complex?

Durable medical equipment isn’t billed like a standard medical service. You’re dealing with product rentals, purchases, repairs, and recurring supplies—all of which must meet strict payer criteria for medical necessity, delivery validation, and proper modifiers.

Some of the most common challenges DME suppliers face include:

1. Insufficient Documentation of Medical Necessity

Most denials stem from inadequate face-to-face encounter notes, missing prescriptions, lack of continued need documentation, or incorrect certificate of medical necessity (CMN) requirements.
We ensure complete, payer-compliant documentation packages before claim submission.

2. Improper HCPCS Coding & Modifier Usage

Billing a wheelchair with the wrong modifier—such as missing the NU (new item), RR (rental), or KX (medical necessity met)—can trigger automatic denials or audits.
Our certified DME coders ensure every item is properly coded, down to the last modifier.

3. Frequent Medicare DMEPOS Audits

The Centers for Medicare and Medicaid Services (CMS) monitor DMEPOS claims closely. Audit triggers include high-dollar equipment, repeat claims, and poor documentation trails.
We help you pass audits with airtight claims, documented proof of delivery, and supplier standard compliance.

4. Complex Payer Rules Across States

Each Medicaid and private payer has its own approved equipment list, prior authorization process, rental conversion guidelines, and utilization frequency rules.
Our state-by-state expertise ensures you're always billing within policy limits and maximizing approvals.

5. Slow Credentialing & Delayed Cash Flow

If you're waiting months to get credentialed with Medicare or commercial payers, you're already losing revenue.
We accelerate your onboarding with fast, efficient DME credentialing that complies with CMS-855S and commercial payer requirements.

Our Full-Suite DME Billing & RCM Services

At Oakview, our DME billing workflows are custom-built for real-world supplier operations. Whether you're handling CPAP supplies, hospital beds, or diabetic shoes, we streamline your entire billing process:

🔹 HCPCS Level II Coding + Modifier Mapping
🔹 Real-Time Eligibility Checks & PA Submission
🔹 CMN/Physician Documentation & Order Audits
🔹 Claim Creation & Submission via Clearinghouse
🔹 Automated Refill Tracking for Recurring Supplies
🔹 Denial Management, Appeals & Payer Escalation
🔹 Payment Posting, Reconciliation & AR Cleanup
🔹 Payer-Specific Audit Readiness & Compliance Reporting
🔹 Monthly Revenue Reporting Dashboards

Our platforms integrate with top DME billing systems (Brightree, Kareo, DMEWorks, TeamDME, Waystar) or we can work within your custom workflows.

DME Credentialing & Supplier Enrollment Services

Credentialing as a DME supplier isn't just about filling out a form—it requires meeting DMEPOS supplier standards, passing site inspections, maintaining proper licensure, and completing CMS-855S enrollment for Medicare. We provide full credentialing for:

✔️ Medicare Part B DMEPOS Enrollment
✔️ Medicaid and Medicaid MCO Panels
✔️ Commercial Payer Networks (Aetna, Cigna, BCBS, UHC, etc.)
✔️ State Licensing & Surety Bond Management
✔️ CAQH Registration & Maintenance
✔️ Revalidation, Updates & Change of Information Filings
✔️ Accreditation Support (ABC, BOC, The Compliance Team, HQAA)

We maintain a cloud-based credentialing tracker to keep your status up-to-date and ensure you never miss a revalidation window or lose active status.

What Types of Equipment Do We Support?

Our experience spans across general and specialty DME categories, including:

• Oxygen & Respiratory Therapy Equipment

• Wheelchairs (Standard, Electric, Manual), Walkers & Scooters

• CPAP/BiPAP Machines & Supplies

• Nebulizers & Respiratory Medications

• Hospital Beds & Lifts

• Wound Care Supplies

• Orthotics & Prosthetics

• Diabetic Testing Supplies & Shoes

• Enteral Nutrition & Feeding Pumps

• TENS Units & Pain Relief Devices

• Durable Urological & Ostomy Products

• Home Infusion Equipment

Why Choose Oakview for Your DME Billing & Credentialing?

🔸 DME-Specific Expertise: Our team is trained exclusively on DMEPOS coding, audit compliance, and supplier billing best practices.

🔸 Compliance-Centric: We align every process with CMS standards and accreditation rules to protect your license and reduce audit exposure.

🔸 Full Transparency: Access real-time claim status, credentialing milestones, and performance dashboards 24/7.

🔸 Faster Payments: We aggressively work denials, shorten DSO, and drive higher clean claim rates with every payer.

🔸 Dedicated Account Teams: You’ll have a dedicated billing manager, credentialing expert, and support rep focused only on your account.

Ready to Maximize Your DME Revenue?

Your equipment improves lives—Oakview ensures you get paid for it. If you’re struggling with low reimbursements, billing delays, or credentialing bottlenecks, we’re ready to streamline it all. Let’s turn your DME business into a revenue engine powered by precision billing and flawless compliance.