Understanding Same and Similar for Medicare

Well, the short answer would be in order to get paid by Medicare for the medical equipment you sold to a patient or customer. In fact, depending on your business checking SnS might be a vital part of it.

Let’s take a look at all the people who would be involved in the life cycle of a patient and their journey to acquiring needed DME/HME.

The first stop for the majority of people will be with a physician. This physician will examine the patient and if needed prescribe durable medical equipment. A physician assistant, nurse practitioner, and clinical nurse specialist can also give a written order for durable medical equipment.

After a patient has been given a written order to receive durable medical equipment, the next step is to find a supplier and give them the written order. Depending on what type of equipment the patient needs, they may have to go in for a fitting and adjustments.

Before you can go ahead and start with the process of selling whichever DME/HME equipment the patient needs, you will have to verify that Medicare will cover the cost. The simplest way to do this would to login to your Episode Alert account. Then navigate to the Same and Similar checkerand run the patient through the system. This will give you a clear picture if they have received the same or similar equipment in the allowed time frame.

We have covered DME equipment specifically but this will also include HME as well, for example, Continuous Positive Airway Pressure (CPAP) devices, Blood sugar monitors, hospital beds, and more.

It is vital that you understand how your dme/hme works. You will be the main person who will need to explain how to use the equipment. Make sure to let your patient know they can ask you as many questions as they need. Here are a few questions, your patient may ask:

  1. If there is a problem with the equipment what do I do?

  2. If I need to readjust something is that covered?

  3. Can I get a replacement if this breaks and will that be covered by Medicare?

Letting your patient know that you are there to help them and that you are knowledgeable about the equipment will often put them at ease and make both of your jobs easier.

We hope this has helped you and we will continue to bring you informative information regarded the DME/HME.