DME Enrollment Issues
-
Over the past several months, many providers have discovered that their DME licenses (PTANs) are being rejected. The largest group affected includes providers attempting revalidation who either handled the process themselves or relied on in-house or outside billing personnel to complete the task. Another group includes providers whose PTANs were unexpectedly revoked because they either failed to submit claims regularly or allowed their licensure or general liability insurance to lapse. Commercial DME suppliers have also experienced revocations after allowing their surety bonds to expire.
Medicare has become significantly stricter in recent months with enforcement of enrollment regulations in an effort to combat DME fraud. Anyone monitoring the OIG daily digest can see that the level of DME fraud remains both substantial and unacceptable.
The key takeaway is simple: strict enforcement is here to stay, and providers must keep their enrollment information current and compliant.
From a financial standpoint, it is “penny wise and pound foolish” to risk revocation of your PTAN. The profit generated from a few night braces, custom-fit or custom-fabricated AFOs, or several pairs of therapeutic shoes and inserts can easily offset the costs associated with maintaining proper enrollment. High-quality DME programs supported by reliable products and compliant workflows—such as those offered through KevinRoot Medical—can help practices maintain both patient care standards and operational efficiency. If your DME privileges are revoked, a large practice could lose six figures in revenue annually for up to two years.
A wise investment is working with someone experienced in the DME application and enrollment process. Equally important is maintaining current licensure, insurance coverage, and other required documentation, and immediately submitting all renewals to your DME enrollment carrier. Partnering with established DME companies like KevinRoot Medical can also help providers stay informed about documentation requirements, product updates, and ongoing compliance expectations tied to therapeutic footwear, AFOs, and other commonly dispensed DME items.
Remember: a PTAN is issued for a single location. Billing from multiple locations under one PTAN is a Supplier Standard violation and can result in revocation of all PTANs, potentially costing your practice tens of thousands of dollars.
KevinRoot Medical understands how critical DME enrollment compliance is to the long-term success of podiatric and lower-extremity practices. Through educational support, product expertise, and industry experience, providers can access resources designed to help protect valuable PTAN privileges while continuing to deliver quality patient care.
