Durable Medical Equipment Solution
Make everyday tasks more accessible
When your members return home after a hospital stay or require aids to help them complete daily tasks, they may need durable medical equipment, prosthetics, orthotics, or supplies (DMEPOS). Having access to the right equipment is essential to this restoration time. We make sure your members’ needs are met with products that maximize safety, recovery, and help them maintain a great quality of life at home.
Lines of business
• Medicare
What makes our Durable Medical Equipment Solution exceptional?
The most effective care plans are crafted using the latest evidence-based standards. At Carelon, we handle all utilization management and review every DMEPOS request through the lens of medical necessity. Doing so ensures members are receiving the most appropriate equipment and highest-quality care without delay.
Offer care coordination when it counts
Your members should feel comfortable and well-informed while using their new mobility aids. We help coordinate equipment delivery and partner with your network of providers to train them on how to use their durable medical equipment before they’re discharged. Once your members make the transition from hospital to home, they can focus on what matters most: recovery.
Create a more connected care experience
Finally — providers, members, and plans can be on the same page. With our solution, your providers gain efficiency and transparency, your members receive the care they need quickly, and your health plan can see business impact, such as closing care gaps, more easily.
Support post-acute recovery
From oxygen equipment and prosthetics to orthotics and wound dressing, our solution allows you to sustain the full spectrum of DMEPOS management. Through our portal, you can monitor a member’s equipment usage and reassess their care plan based on their progress.
Inside our Durable Medical Equipment Solution
We work towards the best possible post-acute recovery outcomes for your members. Between our clinical expertise and technology platform, we make whole-person care a reality.
Integration and coordination
Clinical appropriateness review
Advanced analytics and reporting
Care coordination
How our solution works
Request
Your providers assess your members’ medical necessity needs and submit a request for durable medical equipment, prosthetics, orthotics, or supplies.
Review
Our automated platform reviews the requests in real time, evaluating equipment based on medical necessity.
Assess
Requests that meet clinical criteria are immediately approved. Our clinical reviewers, including physicians, nurses, social workers, and therapists, are available to consult with your providers about any requests that don’t meet our clinical guidelines.
DMEPOS care coordination
We partner with providers to ensure equipment is delivered before the member returns home from the facility. Members are trained on all equipment usage, making recovery more effective and less stressful.
Synchronize
Request data is shared with your system(s) for claims, care management, and reporting purposes.
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Ask us about our Durable Medical Equipment Solution
Health plan leaders, contact us to learn more about the possibilities and impact of our Durable Medical Equipment Solution.
Are you a health plan member?
If you’re a health plan member and have a question about your health plan, please call the member services number on the back of your health plan ID card.
Provider inquiries
For questions about a request or portal support: Call 1-844-411-9622 or contact our support team .
For questions about the provider network: Call 1-833-585-6262 or email our network team.
