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Certified Durable Medical Equipment Specialist

Pharmacy Compliance Guide What is a Certified Durable Medical Equipment Specialist? A Certified Durable Medical Equipment Specialist or a CDME […]

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January 17, 2018 Community Pharmacy

Pharmacy Compliance Guide

What is a Certified Durable Medical Equipment Specialist?

  • A Certified Durable Medical Equipment Specialist or a CDME is a certification created by the BOC or the Board of Certification / Accreditation Int’l
  • BOC saw a need to highlight the skills and qualifications of the highly skilled yet unknown individuals who are key to the dispensing of DME products.
  • The CDME certification demonstrates the broad knowledge of the Durable Medical Equipment (DME) industry.

What does a Certified DME Specialist do?

The CDME basically does every aspect within the DME realm.  They are the people who meet the patients, do the documentation, fit the patients, determine what product the patient is eligible for and bills Medicare, Medicaid and the insurance companies for DME products.  The also help with basic repairs, troubleshooting, and home inspections for DME products like oxygen, transfer systems, enteral supplies, and wound care.

A trained and certified DME specialists are highly valued in the DME industry as an assurance to patients and referral sources of professionalism and quality care. The BOC CDME Scope of Practice provides greater detail regarding the role of a BOC Certified DME Specialist.

Jeff, I really haven’t heard about this before, so what advantage does a pharmacy or DME supplier gain by having a CDME on staff?
This is simple.  We live in a very competitive market.  We need to ensure the pharmacy has unique qualities and products outside the normal pharmacy prescription filling process.  Those days have come and gone.  We have talked about immunizations and diabetic shoes in previous podcasts.  We will talk about other opportunities in future podcasts.
Pharmacists are experts in pharmacy operations.  When it comes to Medicare Part B and DMEPOS products, the rules are completely different.  For example, a physician writes a prescription or eScript and the pharmacist fills the script, the patient picks the medication up and pays their co-pay.  The insurance company and secondary adjudicate the claim and reimburse you for it.  Hopefully there is a low dollar DIR fee so the PBM claw back isn’t too severe next month.
However, when it comes to Medicare Part B, everything changes when the physician writes a prescription.  The pharmacy language stops working.  So you look for someone who can do this work.  What do most pharmacies do? You grab a tech and throw them into this world and let them try to figure it out.  The tech starts reading reading Medicare Supplier Manuals, DME MACs and then learns about Detailed Written Orders and Local Coverage Determination and this doesn’t make sense.  Again the language has changed and there really is only limited training out there for dispensing or billing these products.
This is why the CDME certification was created.  It certifies individuals who have the basic skills for dispensing, setup and billing Medicare Part B and DMEPOS products.
That makes sense.  I have heard about all the audits from Medicare and all the paperwork that is needed.  Jeff, you and I talked about the Diabetic Shoes April 2017 on an earlier podcast last year about the importance of the documentation and following the process.  So this certification helps the pharmacy?
Absolutely.  When you are confused about something or you are losing money and audits, you stop dispensing that item.  This is what has happen with DME products.  Over 40% of DME facilities have gone out of business in the last six years due to competitive bidding.  Pharmacies have dropped DME products because of the bad taste of audits and not understanding the process.
Now imagine having staff properly trained and certified who know what they are doing when it comes to Medicare Part B and DMEPOS products.  They can advise the pharmacist not to fill a prescription of albuterol because it needs a “Detailed Written Order Prior to Delivery” signed by the physician.  Who knew?  Your CDME did.  That saves your reimbursement.
Whoa, is it that simple?
Yes.
Now you are ready to market your pharmacy.  Your pharmacy may be accredited or exempt.  Your pharmacists are licensed.  Are you doing something out of the ordinary to make you stand out?  Your DME department has “board certified” specialists.  Who else in town has this?
Here are some other advantages.
  • Differentiation in the market;
  • Management of risk;
  • Criteria for evaluating potential employees;
  • Limiting of fraud, waste, and abuse;
  • Increase in customer satisfaction;
  • Assurance for referral sources; and
  • Medicare human resources management standards require that technical personnel be knowledgeable, competent, and trained in order to deliver products. A CDME will provide additional assurance of compliance.

How do you get certified?

First here is the criteria for the certification:

  • The candidate needs 500 hours of experience (3 months)
  • A high school diploma (or equivalent)
  • Registers to take an exam with BOC
  • The exam is at a H&R Block testing facility

Another way is through BOC live trainings and then a paper exam following a day long training

When are these trainings scheduled?

There are always two scheduled at Medtrade Spring in Las Vegas and Medtrade Fall in Atlanta.  There are normally two and sometime more classes throughout the year.  BOC’s prep courses are sponsored by MedGroup and are typically $150.00 for the class and $50.00 for the exam.  The paper exam is one to two days after the prep course.

If you have 20 or more people who want to go through the course, a class can always be added to the schedule.

What about the exam?

The exam is a 100 question, 2 hour exam.  To pass the candidate needs to score 70% or higher grade.  It’s not a walk in the park exam.  You need to study for it and taking the prep course or one of the other on-line course before taking the exam.  Currently the passage for the exams following the BOC prep course is 94% with the last class passing 100% and the previous two only having one person falling short by one question.

How do you find out about them?

BOC sends out notices about these courses and so do we through our monthly newsletters.

How are these courses related to you, Jeff?

Well I’m the current BOC Prep course instructor.  When I was on the Board of Directors for BOC, I helped develop a number of projects for BOC and the CDME certification was one of them.  I believe in this certification and I always walk the walk.  Most of my staff also carries this certification.

So you truly believe this will give the pharmacy a competitive edge?

Yes.  Look at your local healthcare providers.  Everyone is boasting about their “board certified” specialists.  Pharmacists are always listed as the most trusted healthcare professionals.  But pharmacy is a lot more than dispensing pills.  Pharmacies have diversified into a multitude of areas.  So here is a way to promote your DME department.  How’s this, come into the Hedges Pharmacy for all of your prescription needs, immunizations and see our board certified DME specialists.  Bet you never heard that one before.  Add this to your Face Book ads.  Show off your staff and let them be part of the revenue stream.

DME is not very sexy, but if you run a tight ship and are careful on what you dispense, document correctly, it will add profit to your pharmacy.  Add diabetic shoes and the profit margin jumps.

 

Notes:

CDME Prep Courses

CFS Allied Health Education “BOC Certified DME Specialist Exam Prep Course”: The objective of this 24-hour, self-paced online course is to provide new and existing DME employees a review of the competencies required to perform tasks in the DME environment. It is an excellent tool to use in preparation for the BOC Certified Durable Medical Equipment Specialist (CDME) certification exam.

MED Group “CDME Specialist Course”: This complete course is a compilation of three CDME Specialist courses. In the courses, you will gain an understanding of: how to create a safe and comfortable environment for your customer, how to conduct yourself as a CDME Specialist, and how to properly fulfill and bill an order. The three courses total approximately 8 self-paced hours of on-line content and instruction and account for 7.25 Business BOC CEUs and 1 Scientific BOC CEU. Please visit this link for pricing information.

O&P Education “CDME-DME Specialist Course”: This course is written to ensure a basic understanding of many aspects of the DMEPOS business and provides guidance for those who wish to endeavor in the proper procedures for a successful business. This course will help to prepare those who anticipate testing for BOC’s Certified DME Specialist examination. Completing this course requires the completion of all 13 sub-courses.

Contact RJ Hedges & Associates today for more information:

Phone: (724) 357-8380  

Email: sales@rjhedges.com