Mastering DME Compliance: Your Path to Success | QPI’s DME Training Center
Medicare Isn’t the Only Game in Town!
The DME Training Center is for those looking to effectively own and operate a Durable Medical Equipment (DME) company. This course offers a comprehensive approach to managing the complexities of DME businesses, especially focusing on record keeping, which is crucial in a constantly evolving industry.
Here’s a quick breakdown of what this course has to offer:
Detailed Training: It's tailored specifically to your company's needs, which could help you streamline operations and stay compliant with industry standards.
90-Day Access: You’ll have 90 days to access the course materials and tools, giving you ample time to absorb the content.
Resources: You’ll have access to helpful resources like sample policies, templates, and rule books that can guide your day-to-day operations.
Knowledge Base Module: A structured way to get the necessary information and resources during your training.
Support: Email [email protected] for any questions, so you can get assistance during your course.
Core Curriculum
Before you sign up, preview five courses for free.
Module 1 Introduction
Available in
days
days
after you enroll
Module 2 Administration: Corporate Structure
Available in
days
days
after you enroll
Module 2 Administration - Accreditation
Available in
days
days
after you enroll
Module 2 Administration - Policies and Procedures
Available in
days
days
after you enroll
- Why Are Policies & Procedures Important?
- Accreditation Compliance
- Regulatory & Medicare Compliance
- Operational Consistency & Training
- Continuous Improvement
- Section 1: General Compliance & Accreditation Alignment
- Section 2: Human Resources & Employee Training
- Section 3: Risk Management & Quality Control
- Section 4: Patient Experience & External Quality Control
- Section 5: Administrative & Operational Compliance
- Section 6: Updates Based on Recent Survey Findings
- Quiz: DME Provider Policies & Procedures Checklist
Module 2 Administration - CMS Supplier Standards
Available in
days
days
after you enroll
Module 2 Administration - CMS Quality Standards
Available in
days
days
after you enroll
- Summary of CMS DMEPOS Quality Standards
- Section I: Supplier Business Services Requirements
- B. Financial Management
- C. Human Resources Management
- D. Consumer Services
- E. Performance Management
- F. Product Safety
- G. Information Management
- Quiz: DMEPOS Supplier Standards outlined in 42 CFR 424.57
- Section II: Supplier Product-Specific Service Requirements
- B. Delivery & Setup
- C. Training & Instructions
- D. Follow-Up Services
- Quiz: Section II: Supplier Product-Specific Service Requirements of the DMEPOS Quality Standards
- Appendices: Respiratory
- Appendix B: Mobility Devices (Wheelchairs & Assistive Technology)
- Appendix C: Prosthetics, Orthotics, & Therapeutic Shoes
- Quiz: DMEPOS Quality Standards Appendices
Module 2 Administration - Purpose of the DMEPOS Supplier Manual
Available in
days
days
after you enroll
- Introduction
- CMS DMEPOS Jurisdiction C Winter 2025 Supplier Manual
- Supplier Enrollment & Compliance
- Supplier Documentation & Orders
- Billing & Claim Submission
- Medicare Coverage & Fee Schedules
- Medicare Secondary Payer (MSP) Rules
- Fraud & Abuse Prevention
- Appeals & Overpayments
- Resources & Education
- Quiz: DMEPOS Supplier Enrollment & Compliance
Module 2 Administration - DME Payer Sequence
Available in
days
days
after you enroll
- Introduction
- Understanding the Beneficiary 20% Co-Pay (0:54)
- CMS Guidelines on Billing the 20% Co-Pay (0:41)
- Policy on Not Sending Separate Statements to Patients
- Best Practices for Compliance
- Primary Payer (First to Bill)
- Secondary Payer (If Applicable)
- Tertiary Payer (If Applicable)
- DME Payer Sequence Illustrated Flowchart
Module 2 Administration - Introduction to Insurances
Available in
days
days
after you enroll
Module 2 Administration - Medicare A-B-C-D Explained
Available in
days
days
after you enroll
Module 2 Administration - Medicare Provider Enrollment - Part 1
Available in
days
days
after you enroll
Module 2 Administration - CEDI - Medicare Provider Enrollment - Part 2
Available in
days
days
after you enroll
- Step 1: Common Electronic Data Interchange (EDI) Transactions with NGS (National Government Services)
- Step 2: EDI Transaction Codes
- Step 3: Trading Partner ID
- Step 4: Crosswalk Your NPI to CEDI
- Step 5: Submit the CEDI NGS Submitter ID Application
- Step 6: Wait for Approval & Obtain Your Submitter ID
- Step 7: Complete Required Testing (If Applicable)
- Step 8: Start Submitting Claims via EDI
- Final Notes & Pro Tips:
- Supporting Documentation
Module 2 Administration - DMEPOS MAC Web Portals - Medicare Provider Enrollment Part 3
Available in
days
days
after you enroll
- DMEPOS Jurisdiction Web Portals & Provider Enrollment
- Key Functions Available on MAC Portals
- Step 1: Registering for DMEPOS Jurisdiction Web Portals
- Step 2: Gather Required Information
- Step 3: Register for a Provider Portal Account
- Step 4: Request Access to Portal Functions
- Step 5: Log In & Start Using the Portal
Module 2 Administration - Medicare Advantage Plans
Available in
days
days
after you enroll
- Introduction to Medicare Advantage Plans
- Steps to Ensure Reimbursement for Medicare Advantage Plans
- Reimbursement Challenges for Medicare Advantage Plans
- Best Practices for Success with Medicare Advantage Plans
- Enrollment Steps
- Credentialing and Contracting
- Managing Claims and Appeals for Medicare Advantage Plans
- Resources to Help with Enrollment and Claims
- Step 1: Introduction to Enroll with MAP’s Timeline
- Step 2: Credentialing & Contracting (Week 3-8)
- Step 3: Preparing for Patient Services (Week 9-12)
- Quiz: Enrolling with Medicare Advantage Plans & Managing Claims
Module 2 Administration - Medicaid - Managed Care Organizations
Available in
days
days
after you enroll
- Introduction to Medicaid
- Understanding Medicaid Managed Care
- Step1: Enroll with a Medicaid MCO – State Medicaid License Required
- Step 2: Complete Medicaid Provider Enrollment
- Step 3: Credentialing & Contracting with the MCO
- Step 4: Verify Network Participation & Training
- Managing Claims & Compliance
- Quiz: Medicaid Managed Care Organization (MCO) Provider Enrollment
Module 2 Administration - In Network Commercial Insurance Carriers
Available in
days
days
after you enroll
Module 2 Administration - Introduction to Out of Network Insurance Carriers
Available in
days
days
after you enroll
Module 2 Administration - Insurance Enrollment Changes
Available in
days
days
after you enroll
Module 2 Administration - Competitive Bid
Available in
days
days
after you enroll
Module 3 Human Resources - Human Resources Department
Available in
days
days
after you enroll
- Introduction
- CMS Requirements for HR Records
- Accreditation Standards (ACHC, BOC, Joint Commission, etc.)
- State HME Licensing Requirements
- Licensed Providers (Pharmacists, Respiratory Therapists, etc.)
- Human Resources Department Checklist
- Background Checks & Compliance Training
- Provider Vaccination Requirements
- Quiz: CMS Requirements for HR Records & Compliance
- Bonus Lesson - Equipment Overview, Fee Schedules, Cost, ROI Video
Module 3 Human Resources - Job Descriptions
Available in
days
days
after you enroll
- DME Provider Job Descriptions: Importance & Key Roles
- Ensuring Compliance & Best Practices
- Essential DME Provider Job Descriptions
- Essential DME Provider Job Descriptions | Compliance Officer
- DME Technician
- Respiratory Therapist (if applicable)
- Customer Service Representative (CSR)
- Billing & Reimbursement Specialist
- Delivery Technician
- Warehouse/Inventory Manager
- Quiz: DME Provider Job Descriptions & Compliance
Module 3 Human Resources - DME Evaluation and Skills Assessments Examples
Available in
days
days
after you enroll
- DME Evaluations & Skills Assessments: Ensuring Competency and Compliance
- DME Technician Competency Checklist
- Respiratory Therapist (RT) Competency Checklist
- Customer Service Representative (CSR) Skills Assessment
- Billing & Reimbursement Specialist Assessment
- Warehouse/Inventory Manager Assessment
- Performance Evaluations & Competency Review Process
- Quiz: DME Evaluations & Skills Assessments
Module 3 Human Resources - DME Equipment Training
Available in
days
days
after you enroll
Module 4 Risk Management - Introduction to Risk Management
Available in
days
days
after you enroll
- Understanding Risk Management and DME Billing
- Regulatory Compliance
- Internal Controls and Fraud Prevention
- Patient Safety & Quality Assurance
- Financial Risk Mitigation
- Overview of DMEPOS Billing Process | Patient Eligibility Verification
- Patient File Documentation Requirements
- Claim Submission and Coding
- Denials, Appeals, and Audits
- Best Practices for Risk Reduction in Billing
Module 4 Risk Management - Medicare Fee Schedule
Available in
days
days
after you enroll
- Overview of the DMEPOS Medicare Fee Schedule
- Key Components of the DMEPOS Medicare Fee Schedule
- “Ceiling” and “Floor” Reimbursement Limits
- Payment Methodologies
- Rural vs. Non-Rural Reimbursement
- Beneficiary Cost-Sharing
- Adjustments & Annual Updates
- How to Access the DMEPOS Medicare Fee Schedule
- Quiz: DMEPOS Medicare Fee Schedule
Module 4 Risk Management - Billing - Local Coverage Determinations (LCD's)
Available in
days
days
after you enroll
Module 4 Risk Management - Pricing Data Analysis and Coding (PDAC)
Available in
days
days
after you enroll
Module 4 Risk Management - Billing - State License Directory
Available in
days
days
after you enroll
Module 4 Risk Management - Patient Eligibility
Available in
days
days
after you enroll
- How to Verify Patient Eligibility for DMEPOS Products and Services
- Step 1: Verify the Patient’s Insurance Coverage
- Step 2: Confirm HCPCS Code Coverage
- Step 3: Review Local Coverage Determinations (LCDs) & Medical Necessity
- Step 4: Check Prior Authorization & Documentation Requirements
- Step 5: Verify Patient Financial Responsibility
- Step 6: Document & Maintain Compliance Records
- Prevent Billing Issues with Pre-Verification
- Quiz: DMEPOS Patient Eligibility Verification
Module 4 Risk Management - Patient Documentation Requirements
Available in
days
days
after you enroll
- DMEPOS Patient Documentation Requirements & Supplier Responsibilities
- Key Documentation Requirements for DMEPOS Suppliers
- Required Documentation Before Claim Submission
- Advance Beneficiary Notice (ABN) – When to Issue
- Delivery and Pickup Documentation
- Backup Equipment Policy
- Supplier Record-Keeping Requirements
- DMEPOS Fee Schedules & Billing Rules
- Medicare Participating vs. Non-Participating Suppliers
- Quiz: DMEPOS Patient Documentation Requirements
Module 4 Risk Management - Patient Order Intake
Available in
days
days
after you enroll
- Patient Order Intake Form
- Patient Information
- Insurance Information
- Prescribing Licensed Independent Practitioner Information
- Equipment Ordered
- Insurance & Billing Verification
- Required Documentation Checklist
- Compliance & Documentation Requirements
- Use QPI Healthcare Services LLC’s Pre-Billing Checklist
- Quiz: Patient Order Intake Form
Module 4 Risk Management - Patient Pre Billing Checklist
Available in
days
days
after you enroll
- Pre-Billing Checklist
- Key Components of the Checklist
- Order Validation
- Medical Necessity & Documentation Compliance
- Competitive Bidding & Supplier Compliance (if applicable)
- Pre-Delivery & Billing Verification
- Proof of Delivery & Refill Requirements
- Compliance with Medicare Guidelines
- Quiz: Pre-Billing Checklist
Module 4 Risk Management - Patient Claim Development
Available in
days
days
after you enroll
Module 4 Risk Management - Provider Responsibilities - Fraud Waste and Abuse
Available in
days
days
after you enroll
Module 4 Risk Management - Provider Responsibilities -Incident Reporting
Available in
days
days
after you enroll
- CMS & Accreditation Organization Regulations on Incident Reporting
- Incident Report Supporting Documentation
- CMS Regulations on Incident Reporting
- Mandatory Reporting of Serious Incident
- Incident Investigation & Root Cause Analysis
- Incident Reporting System & Record Retention
- Reporting to CMS & State Agencies
- Accreditation Organization Requirements on Incident Reporting
- BOC (Board of Certification/Accreditation) Standards
- The Joint Commission (TJC) Standards
- Consequences of Non-Compliance with Incident Reporting Regulations
- Best Practices for CMS & Accreditation-Compliant Incident Reporting
- Quiz: CMS & Accreditation Organization Regulations on Incident Reporting
Module 4 Risk Management - Provider Responsibilities - Annual Performance Improvement Reporting
Available in
days
days
after you enroll
- DMEPOS Annual Performance Improvement Report
- Key Components of the Report
- Performance Measures (Ongoing Monitoring)
- DME Quality Review Numbers (Quality Assurance Checks)
- Patient Rights & Responsibilities / Patient Surveys (Patient Feedback Mechanism)
- Patient Abuse Reports / Patient Complaints & Grievances (Risk & Compliance Monitoring)
- Board of Directors (BOD) Meetings (Governance & Compliance Oversight)
- Importance of the Annual Performance Improvement Report
Module 4 Risk Management - Provider Responsibilities - Risk Management Activities
Available in
days
days
after you enroll
- Introduction to Risk Management Activities
- Billing & Coding Error Logs
- Emergency Drills & Fire Drills
- Facility Safety Inspections
- Hazard Vulnerability Analysis (HVA)
- HIPAA Assessments
- In-Service Training for Staff
- OSHA Assessment
- Patient Experience Surveys
- The Joint Commission - Root Cause Analysis (RCA) – Required for Sentinel Events
- Quiz: CMS Risk Management & Compliance
Module 5 Patient Outcomes - Building DME to Healthcare Provider Relationships
Available in
days
days
after you enroll
- Building Local Provider Relationships as a DME Provider
- Home Health Agencies (HHA) (2:07)
- Assisted Living Facilities (3:29)
- Skilled Nursing Facilities (SNFs) (5:49)
- Hospitals
- Clinic Groups
- Hospice Providers (13:24)
- Air Pressure Mattress and Low Air Loss Systems (2:07)
- Wheelchair Campaign
- Leveraging These Relationships for Business Growth
Module 5 Patient Outcomes - Best Marketing Practices
Available in
days
days
after you enroll
Module 5 Patient Outcomes - Third Party Marketing Compliance
Available in
days
days
after you enroll
Module 5 Patient Outcomes - Know Your Equipment - In Service Training
Available in
days
days
after you enroll
Module 5 Patient Outcomes - AIDET Method - Acknowledge - Introduce - Duration - Explanation
Available in
days
days
after you enroll
Module 5 Patient Outcomes - Establishing A Solid Patient Workflow
Available in
days
days
after you enroll
Module 5 Patient Outcomes - Handling Complaints and Grievances
Available in
days
days
after you enroll
Module 5 Patient Outcomes - Patient Experience Surveys
Available in
days
days
after you enroll
Module 6 QPI Healthcare Services
Available in
days
days
after you enroll
Knowledge Base
Available in
days
days
after you enroll
- CMS Program Integrity Manual 2025
- CMS Quality Standards Manual 2025
- CMS Thirty Supplier Standards Long Version
- DME Jurisdiction C Winter 2025 Supplier Manual
- DMEPOS Fee Schedule Jan 2025
- Medicaid Fraud Control Units Fiscal Year 2023 Annual Report
- New Supplier Training Checklist
- Online Resources with Links
- Pricing, Data, Analysis and Coding (PDAC) Video - Noridian
- Provider Enrollment, Chain and Ownership System (PECOS)
- The Structure of Medicare
- Fee Schedule Payment Categories
- Paperwork Documentation Supporting Claims (PWK)
- Place of Service
- Local Coverage Determinations
- Non Covered DMEPOS Items
- Common Data Interchange (CEDI)
- Medicare Learning Network (MLN) Products
- Noridian Medicare Portal - Eligibility
- Incident Report
- Facility Safety Inspection Form
- Fire Drill Report
- Hazard Vulnerability Analysis
- In Service Training Form
- HIPAA Assessment
- Patient Experience Survey
- TJC Sentinel Event Policy
- Manual Wheelchair Campaign
- Manual Wheelchair Campaign ALCO-EP3
- Manual Wheelchair Campaign - Medco Wheelchair Washer Equipment
- Manual Wheelchair Campaign - Medco Wheelchair Washer System
- Manual Wheelchair Campaign - Wheelchair Options Accessories LCD and PA
- Manual Wheelchair Campaign - Wheelchair Safety & Maintenance Guidelines & Checklist
- Manual Wheelchair Campaign - Wheelchair Manual Refurbchecklist
Check your inbox to confirm your subscription