EZ-DME Service Plans
Service Plans To Fit Your Needs
EZ-DME offers service plans to fit the needs of your business and your special claims.
Level 1: Basic Basic Claims
Claims can be captured using National Council for Prescription Drug Programs (NCPDP) variable length format through your pharmacy software application or can be entered through a secure Internet portal. These claims are for covered items delivered to the patient's home that do not require additional information such as CMNs.
Billable items include, but are not limited to, Diabetic testing supplies (e.g., test strips and lancets), inhalation drugs, and immunosuppressive drugs.
Plan Pricing
- $ 0.75 per claim
Rentals are entered into the system once and billed automatically until the item is picked up from the patient.
Level 2: Intermediate Claims
Claims can be sent to the payor electronically, but require additional information such as facility names, addresses, Certificate of Medical Necessity (CMN) information, or other data that must be updated by the billing entity on our secure Internet site. Billable items must be delivered to the patient's home.
Plan Pricing
- $ 1.25 per claim for primary claim
- $ 0.75 per item for secondary claims that do not automatically crossover from the payor.
EZ-DME Plus Backend Services
The EZ-DME Plus Plan is available via the EZ-DME web portal via a secure and personalized login.
- Available via EZ-DME web portal with secure, personalized login
- Secondary claims that do not crossover can be automatically sent to the secondary payor after patient and remittance information has been updated.
- Recurring claims for rentals are entered into the system once and automatically billed monthly or according to capped rental logic where applicable. Claims are held for purchase option letters, billed for maintenance months, etc. until the item is picked up from the patient.
- Rejections from either the front end of the payor or your 835 remittances are populated in a Reject queue with additional tips on how to correct the errors. As soon as the corrections are made, EZ-DME resends these claims automatically.
- Reconciliation of your DME claims is automatic when your 835 electronic remittances are available. Manual payments are easily applied for full accounting of all your claims.
- The EZ-DME Plus Plan includes reporting tools to manage and grow your DME business.
Plan Pricing
- $129.00 per month, plus applicable claim fees for Level 1 and Level 2 claims
Requirements
Visit these EZ-DME web pages for detailed information about these important requirements:
| Requirement | See Page |
| Valid Medicare Provider Number |
How To Enroll |
| Valid National
Provider ID Number (NPI) |
How To Enroll |
| Registration with all four DME Medicare Administrative Contractors (DME MACs) | DME MAC Regions |
| Registration with desired State Medicaid Programs | State Medicaid Contacts |
| FDS Service Agreement | How To Enroll |
| Compatible pharmacy software or access to our secure EZ-DME website |
Prior Authorization Numbers
- To send a claim for Basic Service - A Prior Authorization number is usually not required. Some states may require a Prior Authorization Code for certain items.
- To send a claim for Intermediate Service - Use PA/MC Code 1 (numeral one) and Prior Authorization Number 8888.
Rejected Claims
FDS' EZ-DME rejects a claim if it does not meet the necessary criteria - for missing or invalid information - to bill Basic Service unless you include a Prior Authorization Number to submit as a Level 2 Intermediate claim the first time you submit the claim.
FDS charges a $ 0.10 fee for each rejected claim.
- If a Customer knows that a claim requires additional information needing Intermediate Service, the Prior Authorization Number can be entered the first time the claim is transmitted allowing the claim to flow into the chosen level of service.
- FDS' EZ-DME rejects the claim with a rejection code that tells the Customer to resubmit with a Prior Authorization Number.
