Utilization management is key to keeping your customers and your bottom line healthy. Durable Medical Equipment (DME) is expensive and determining coverage and medical necessity is complex.
Frequently, DME is an under-managed benefit. Whether its a lack of personnel, a poor understanding of the disease process or an inadequate grasp of the medical necessity criteria, utilization management of DME can be a weak link in an organization.
The Cadenza Health team has been reviewing requests for DME for many years now. We have garnered an understanding of the coverage and medical necessity criteria during this time. We have developed insight into how DME providers operate as well. Our experience includes basic requests for lower cost items but also includes daily reviews of costly equipment such as prosthetics and power mobility devices. Let us help your organization lower your DME burden with better utilization reviews.