Durable Medical Equipment (DME)

If your client is covered by a managed care organization such as:

• Community Health Plan of Washington (CHPW)
• Coordinated Care (CC)
• Molina Healthcare of Washington (MHW)
• UnitedHealthcare Community Plan of Washington (UHC)
• Wellpoint Washington (previously Amerigroup) (WLP)

Contact the plan directly for program benefits.

Provider guides

• Complex Rehabilitation Technology (CRT)
• Durable Medical Equipment (DME)  and Noncomplex Rehabilitation Technology (CRT) wheelchairs
• Enteral nutrition
• Medical supplies and equipment fee schedule
• Nondurable Medical Supplies and Equipment (MSE)
  • Includes information about diabetic testing supplies, incontinence supplies, braces, etc.
• Prosthetic and orthotic devices
• Respiratory care

Limitation extension

WAC 182-501-0169 allows clients receiving any of these services to request an exception to the limits if their health care needs are not being met.

Did you know?

You can contact the client's case worker to get assistance with the required documentation. You can do this at any time during the DME authorization process.

Patient specific information must be sent via secure email to protect patient privacy and comply with HIPAA regulations. 

When sending emails, we suggest the following subject lines to help expedite response time.

• Expedite for D/C (discharge within one week)
• Expedite: client safety concerns
• Rates Request (the rate does not cover the cost of the item)
• Limitation extension
• When Medicare is primary payer, but client does not meet Medicare medically necessary criteria, enter "Does not meet Medicare MN criteria"

Resources

• DME provider webinar presentation
• Diabetes supplies (limitation extension request)
• Bathroom equipment (limitation exception to rule)
• Compression garments (limitation exception to rule)
• Incontinent supplies (limitation extension request)
• Enteral nutrition (exception to rule)
• Fee-for-service providers of nonsterile gloves
• General information for authorization (13-835)
• Protective gloves available for providers