DME Case Auditor
As a Durable Medical Equipment auditor it will be your job to determine whether an item deemed ‘medical equipment’ will be covered by Medicare. It will be your job to examine and conclude if various items are necessary for the upkeep of a patient on Medicare.
In order for equipment to be covered by Medicare, you will have to decide if:
- The medical device in question has been prescribed as medically essential by a physician
- It must be used for a medical purpose and not useful for someone who doesn’t have an injury or illness
- The product can tolerate repetitive use, as Medicare expects the quality of equipment to last over 5 years
- If the equipment in question is supplied by an approved Medicare supplier
- If the DME is appropriate, and safe, to use at home.
Requirements:
- HS Diploma
- Bachelor’s Degree in related field
- Certification from the American Academy of Professional Coders (AAPC) or
- the American Health Information Management Association (AHIMA)
It is always encouraged when auditing for the government that you make suggestions for improvement if you see a way in which the system is flawed. It is important as a DME Auditor to familiarize yourself with medications, procedures, medical services, and diagnoses.