Full Answer
What is the DME Mac jurisdiction?
The DME MACs process Medicare Durable Medical Equipment, Orthotics, and Prosthetics (DMEPOS) claims for a defined geographic area or "jurisdiction," servicing suppliers of DMEPOS. Learn more about the DME MAC in each jurisdiction. DME MAC Jurisdiction A DME MAC Jurisdiction B
What does DME Mac stand for?
Durable Medical Equipment Medicare Administrative Contractors is the current name of the Durable Medical Equipment Regional Carriers. Prior to the DME MAC label, they were also called Medicare A/B contractors.
What does dmdmerc stand for in medical billing?
DMERCs were the Durable Medical Equipment Regional Carriers. The name change occurred in 2007. Durable Medical Equipment Medicare Administrative Contractors is the current name of the Durable Medical Equipment Regional Carriers. Prior to the DME MAC label, they were also called Medicare A/B contractors.
What is DME Mac Region B?
Region B: DME MAC is CGS, a Celerian Company. CGS is the DME MAC for Region B. This region consists of the states of Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio, and Wisconsin.
What is DME MAC C?
A Durable Medical Equipment Medicare Administrative Contractor (DME MAC) is a private insurance company that has a contract with Medicare to process durable medical equipment (DME) claims.
What is jurisdiction C for Medicare?
Jurisdiction C is serviced by CGS and includes Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, Virginia, West Virginia and the US Virgin Islands.
What does DME MAC mean?
DME MACs. The DME MACs process Medicare Durable Medical Equipment, Orthotics, and Prosthetics (DMEPOS) claims for a defined geographic area or "jurisdiction," servicing suppliers of DMEPOS.
Which of the following claims are handled by the DME MACs?
DME MACs handle claims for durable medical equipment, supplies, and drugs billed by physicians.
Who is the Mac for Missouri?
The Missouri Association of Counties (MAC), formed in 1972, is a nonprofit, nonpartisan member service organization dedicated to the improvement of county government.
What is the MAC for Florida?
First Coast has proudly served as one of the nation's largest Medicare administrators for 50 years, and is the current Medicare Administrative Contractor (MAC) for Jurisdiction N (JN), which includes Florida, Puerto Rico and the U.S. Virgin Islands.
What does a Medicare Mac do?
A Medicare Administrative Contractor (MAC) is a private health care insurer that has been awarded a geographic jurisdiction to process Medicare Part A and Part B (A/B) medical claims or Durable Medical Equipment (DME) claims for Medicare Fee-For-Service (FFS) beneficiaries.
How many MACs are there for the DME?
FourHow Many Macs Exist? Currently, there are 12 Medicare Part A and B MACs that assist with Original Medicare (Medicare Parts A and B). Four of these MACs also process home health and hospice claims in addition to their typical Medicare Part A and Part B claims. There are also four durable medical equipment (DME) MACs.
What is the difference between RAC and MAC?
MAC audits are powerful and intrusive procedures that have the potential to lead to serious federal charges for healthcare entities. A Recovery Audit Contractor (“RAC”) reviews claims and identifies overpayments from Medicare so that CMS and other auditors are able to prevent improper payments in the future.
What is the purpose of Part C Medicare quizlet?
The main purpose of Medicare Part C is to reduce the financial strain on Medicare funds by providing access to a variety of new health options to beneficiaries and thus incentivizing beneficiaries to join private health care plans as an alternative to the fee-for-service Medicare program.
How do I submit a DME claim to Medicare?
Contact your doctor or supplier, and ask them to file a claim. If they don't file a claim, call us at 1-800-MEDICARE (1-800-633-4227). TTY: 1-877-486-2048. Ask for the exact time limit for filing a Medicare claim for the service or supply you got.
How many jurisdictions are there in Medicare?
Centers for Medicare and Medicaid Services (CMS) announced in 2010 plans to reduce the number of A/B Medicare Administrative Contractors (MACs) from the current numbered 15 jurisdictions to 10 alphabetical jurisdictions over the next several years.
Current Maps and Lists
To find out who the current A/B and DME MACs are, use these maps and lists to help you determine which MAC is of most interest to you.
DME MACs
The DME MACs process Medicare Durable Medical Equipment, Orthotics, and Prosthetics (DMEPOS) claims for a defined geographic area or "jurisdiction," servicing suppliers of DMEPOS. Learn more about the DME MAC in each jurisdiction.
License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition
Enter your ANSI denial code from your RA into the Claim Denial Resolution Tool to view details and access education to help you resolve the claim.
Recent News
Visit the Jurisdiction C News page for all articles, alerts and updates.
Education Opportunities: Workshops, Webinars & More
External Breast Prostheses February 18 Get all the information you need to bill external breast protheses and related supplies compliantly. As always, there will be time for questions following the presentation. Reserve your space today.
How many DME MAC agreements does Medicare have?
Medicare has four DME MAC agreements; each establishes authority to oversee Medicare durable equipment transactions in a region of the nation and territories.
What is the purpose of DME MAC?
The purpose of the Durable Medical Equipment Regional Carrier and now the DME MAC is to service the medical equipment needs of beneficiaries in a designated territory. Medicare provides durable medical equipment to beneficiaries on a buy or lease basis.
How does DME MAC work?
The DME MAC works with the essential flow of claims and payments that keep Medicare beneficiaries supplied with medically necessary home equipment. Time is of the essence in every transaction because the underlying situation is one that involves the health and well-being of the beneficiaries.
How long does it take for a DME to be paid for by Medicare?
The rules require a doctor’s visit within six months of the DME prescription in which the patient discusses his or her need for the item with the doctor.
What is claims processing in Medicare?
The DME MACs process claims, review medical information, review appeals, and process payments. The claims processing manual helps ensure uniform approaches and fair treatment for beneficiaries regardless of location or type of request.
What is the primary role of a durable medical equipment contractor?
The primary role of the Durable Medical Equipment Medicare Administrative Contractors is for health care claims processing, and payment or reimbursement for Original Medicare and Medicare Advantage Plans. The payment and processing is an enormous task involving high volumes of requests for equipment, prosthetics, orthotics, and supplies.
How many DMERC companies does Medicare use?
Medicare used four DMERC companies to cover the US and territories. DMERC companies operated the purchasing lists of qualified durable equipment. DMERC companies trained and assisted suppliers of durable equipment. DMERCs were the Durable Medical Equipment Regional Carriers. The name change occurred in 2007.
