Durable Medical Equipment (DME) Credentialing FAQ
DMEPOS Accreditation, Medicare/Medicaid Enrollment, and HCPCS Billing FAQs - Simplified
1. Why is credentialing essential for DME suppliers?
Credentialing is mandatory for billing Medicare, Medicaid, and commercial payers for DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies). Without credentialing, your claims will be denied, halting cash flow.
TriumpHealth helps DME businesses get credentialed faster, stay compliant, and start billing sooner, while minimizing paperwork and payer delays.
2. What does TriumpHealth’s DME credentialing service include?
Our DME credentialing solutions cover:
- Medicare 855S enrollment (required for all DMEPOS providers)
- State Medicaid enrollment and managed care credentialing
- Commercial payer applications (e.g., BCBS, Aetna, UHC, Cigna)
- Surety bond verification and support
- Type II NPI registration and taxonomy code setup
- Accreditation coordination (CHAP, ACHC, TJC, etc.)
- PECOS and CAQH profile setup
- Ongoing revalidation and recredentialing
- Tracking of all applications with centralized status reporting
- Payer contract negotiation (if applicable)
TriumpHealth serves new DME start-ups, mobile units, pharmacy-affiliated DME suppliers, and national distributors.
3. What are the requirements to enroll with Medicare as a DMEPOS supplier?
To enroll with Medicare, you must:
- Complete the CMS-855S application
- Obtain a $50,000 surety bond per NPI
- Maintain accreditation by a CMS-approved organization
- Register with PECOS and obtain a Type II NPI
- Be in compliance with supplier standards (42 CFR §424.57)
- Maintain a physical location, signage, hours of operation, and liability insurance
TriumpHealth manages the entire Medicare enrollment process, ensuring that each element is in place for successful submission.
4. How long does it take to get credentialed with Medicare and other payers?
Typical credentialing timelines:
- Medicare (855S) ~90-150 days
- State Medicaid ~60–120 days, depending on the state
- Commercial payers ~60–180 days
TriumpHealth keeps credentialing on track by providing payer-specific documentation support, follow-up, and issue resolution.
Please Note: These timelines are general estimates and may vary based on payer-specific processes, state regulations, application completeness, and responsiveness to follow-up requests. Delays may also occur due to payer backlogs or additional documentation requirements.
5. What DME specialties and products can TriumpHealth credential?
We support credentialing across a wide range of DME categories, including:
- Orthotics and prosthetics
- Diabetic supplies
- Mobility aids (wheelchairs, walkers, scooters)
- Respiratory equipment (CPAP, BiPAP, oxygen supplies)
- Hospital beds and patient lifts
- Urological and ostomy supplies
- Negative pressure wound therapy (NPWT)
- Home infusion and enteral nutrition
- Custom DME and pharmacy-affiliated supplies
TriumpHealth tailors credentialing based on your product categories, delivery model, and target payer mix.
6. Is accreditation required for DME suppliers?
Yes. CMS requires accreditation by a recognized organization (e.g., CHAP, ACHC, TJC, BOC) before approving Medicare enrollment.
TriumpHealth helps you:
- Choose the right accrediting body
- Prepare policies, procedures, and compliance documentation
- Schedule and prepare for your on-site survey
- Stay compliant with post-survey updates
We also help track re-accreditation timelines and renewal requirements.
7. Can a mobile or home-based DME supplier get credentialed?
Yes, but specific rules apply. CMS and payers typically require:
- A verifiable physical location with posted hours and signage
- Separate entrance and business license if operating from a residence
- Proof of inventory, delivery logs, and billing infrastructure
TriumpHealth advises on how to set up your business for credentialing success and regulatory compliance, even as a mobile or hybrid DME model.
8. How does TriumpHealth manage revalidations and ongoing compliance?
Credentialing isn’t a one-time task. Medicare, Medicaid, and commercial payers require revalidations every 3-5 years or after key changes (e.g., ownership, address, licensure).
TriumpHealth offers:
- Credentialing monitoring dashboards
- Revalidation alerts and document preparation
- PECOS and CAQH updates
- Change of ownership (CHOW) filings
- Compliance advisory and audit readiness
9. What if our DME company is expanding or opening new locations?
Each new location or NPI requires:
- A new 855S submission or PECOS update
- Surety bond and accreditation extension
- Updated licensure and business registration
TriumpHealth manages multi-location expansion plans, so you can scale confidently without missing compliance steps.
10. How do we get started with TriumpHealth’s DME credentialing services?
TriumpHealth is your dedicated credentialing partner for DME growth, compliance, and reimbursement success, from Medicare 855S to multi-state expansion.
Schedule a free consultation to assess your credentialing readiness and timeline. We’ll walk you through Medicare, Medicaid, commercial payer requirements, and help you choose the right credentialing and accreditation path. You can always contact us via email [email protected] or call (888) 747-3836 x0.
Learn more: TriumpHealth DME Services
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