What does it take to open a DME business?
(relax, Johnny, I'm not planning to compete with cpap.com, no way!)
My question relates to whether there are extra hurdles, extra licensing, extra training, special certification, an RT, a medical director, state licenses, etc. required to open a brickin' mortar DME shop??? That is, above and beyond, say, what it takes to open a restaurant or a yogurt stand. Does anybody know? THANKS!
-HKS
what does it take?
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harikarishimari
- Posts: 70
- Joined: Thu Dec 15, 2005 6:22 pm
- Location: NV
what does it take?
Seek counsel of him who makes you weep, and not of him who makes you laugh.
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Guest
Re: what does it take?
yes, yes, yes, yes, usually, not really, yes.harikarishimari wrote:What does it take to open a DME business?
My question relates to whether there are extra hurdles, extra licensing, extra training, special certification, an RT, a medical director, state licenses, etc. required to open a brickin' mortar DME shop??? That is, above and beyond, say, what it takes to open a restaurant or a yogurt stand. Does anybody know? THANKS!
-HKS
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Darth Vader Look
- Posts: 411
- Joined: Fri Dec 30, 2005 3:15 am
Money, a good business ethic, city required business license, signed agreement with manufacturers of the product.What does it take to open a DME business?
If special certification, extra training, medical director and an RT are needed you sure could fool me because I have never seen this at the DME's I visited and/or used. Okay maybe the extra training in how to bamboozle the client into believing everything you say is true using a straight face. Hell, they probably make excellent poker players with those straight faces. .
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harikarishimari
- Posts: 70
- Joined: Thu Dec 15, 2005 6:22 pm
- Location: NV
If a prescription is required, does the state/federal govt have some kind of special licensing requirement so they know where to send the SWAT team if the signatures are illegible or don't match? Does Nevada (or any other state) really require a prescription for a mask, like my DME is telling me? Or is it the insurance companies that have that requirement? That seems pretty silly.
I would like to see something objective in writing or a reference that spells out the rules. Is there a book ("DME for Dummies"?), or a law or a regulatory something-or-other that applies? An entry in the Federal Register? Seems like there is too much smoke and mirrors to sort this out. At this point it seems like all you need is a business license, a product source, nine months of serious gestation and a birth certificate. Is there more to it?
I am of the opinion that instead of whining about competition and lack of monopolistic price supports, the "stationary" DMEs should re-invent themselves and behave more like the online vendors. It's a myth that online xPAP vendors have no overhead. It's also a myth that a majority of DMEs provide any kind of value-added service. As for the nonsense about trying on masks, my DME did not take any measurements, sold me the wrong size mask, would not take it back, required another prescription for selling me the correct size, which I paid OUT OF POCKET! (That was about a year ago when I was young and foolish and didn't know about cpap.com). I have had far more support and good advice on this forum than I would ever have from my DME, who continues to inform me that "APAP doesn't really exist, that it's only "experimental", that insurance won't pay for it, that it doesn't work for pressures over 10 cm, and yada-yada-yada-yada").
The dialogue here is open and candid and genuinely helpful. Thank you Johnny and cpaptalk.com and all the actual real CPAP users here whose advice I have learned to trust. And thank-you to DME_guy and other honest DMEs who truly provide good advice and good service. I know they exist. I wish there were more of them.
Sincerely,
-HKS
(I also promise to boycott all Resmed products if they are so foolish as to selectively raise prices for one segment of the market over another. The few dollars I won't spend in their direction won't hurt their business much, and probably won't even be noticed. I will also take every opportunity to spread the word about "Resmed-friendly" brick-and-mortar DMEs who post here and are jumping up and down with glee over the prospect of raising prices for EVERYBODY, and making this important technology even less accessible to those who need it most. They should not be rewarded.)
I would like to see something objective in writing or a reference that spells out the rules. Is there a book ("DME for Dummies"?), or a law or a regulatory something-or-other that applies? An entry in the Federal Register? Seems like there is too much smoke and mirrors to sort this out. At this point it seems like all you need is a business license, a product source, nine months of serious gestation and a birth certificate. Is there more to it?
I am of the opinion that instead of whining about competition and lack of monopolistic price supports, the "stationary" DMEs should re-invent themselves and behave more like the online vendors. It's a myth that online xPAP vendors have no overhead. It's also a myth that a majority of DMEs provide any kind of value-added service. As for the nonsense about trying on masks, my DME did not take any measurements, sold me the wrong size mask, would not take it back, required another prescription for selling me the correct size, which I paid OUT OF POCKET! (That was about a year ago when I was young and foolish and didn't know about cpap.com). I have had far more support and good advice on this forum than I would ever have from my DME, who continues to inform me that "APAP doesn't really exist, that it's only "experimental", that insurance won't pay for it, that it doesn't work for pressures over 10 cm, and yada-yada-yada-yada").
The dialogue here is open and candid and genuinely helpful. Thank you Johnny and cpaptalk.com and all the actual real CPAP users here whose advice I have learned to trust. And thank-you to DME_guy and other honest DMEs who truly provide good advice and good service. I know they exist. I wish there were more of them.
Sincerely,
-HKS
(I also promise to boycott all Resmed products if they are so foolish as to selectively raise prices for one segment of the market over another. The few dollars I won't spend in their direction won't hurt their business much, and probably won't even be noticed. I will also take every opportunity to spread the word about "Resmed-friendly" brick-and-mortar DMEs who post here and are jumping up and down with glee over the prospect of raising prices for EVERYBODY, and making this important technology even less accessible to those who need it most. They should not be rewarded.)
Seek counsel of him who makes you weep, and not of him who makes you laugh.
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OwlCreekObserver
- Posts: 459
- Joined: Thu Jun 01, 2006 6:45 pm
- Location: Northwest Arkansas
Disclaimer: Though I once worked for a DME, it was in a technical support role. My "expertise" in the regulatory and operational requirements is based solely on what I observed. Your mileage may vary.
I would expect that at least some states have licensing requirements. In most cases you'd have to pass periodic JACO (Joint Commission on Accreditation of Healthcare Organizations) inspections, which can be a bit of a hassle.
Of course you would be purchasing most everything on credit so you'd have to establish lines of credit with all the manufacturers and wholesalers who would be supplying you. Obviously you'd have to be on very good terms with your bank as well.
Medical billing can be a nightmare unless you really know what you're doing. No, that's not right. Medical billing is a nightmare!
Medicare billing can be a long and painful process and you can find yourself defending your actions in federal court, no matter how careful you are. Many states (like Illinois) are E-X-T-R-E-M-E-L-Y slow in paying their bills so Medicaid money is often slow in arriving. Because you need the business, you really have no choice but to suck it up and hope that your receivables arrive before your payables are due.
I don't think it's necessarily required that you have medical professionals on staff but my company always had at least a couple of RNs to work with doctors, hospitals, and nursing homes.
You need a good office support staff, a super sales staff that keeps the customers coming in (good luck with that one), skilled service techs with winning personalities who know what they're doing (ditto) and possibly an equipment repair person, a warehouse person, etc., etc., etc.
In my opinion there are easier businesses to operate, but the folks I've known in the DME trade generally enjoy what they do.
OCO
I would expect that at least some states have licensing requirements. In most cases you'd have to pass periodic JACO (Joint Commission on Accreditation of Healthcare Organizations) inspections, which can be a bit of a hassle.
Of course you would be purchasing most everything on credit so you'd have to establish lines of credit with all the manufacturers and wholesalers who would be supplying you. Obviously you'd have to be on very good terms with your bank as well.
Medical billing can be a nightmare unless you really know what you're doing. No, that's not right. Medical billing is a nightmare!
Medicare billing can be a long and painful process and you can find yourself defending your actions in federal court, no matter how careful you are. Many states (like Illinois) are E-X-T-R-E-M-E-L-Y slow in paying their bills so Medicaid money is often slow in arriving. Because you need the business, you really have no choice but to suck it up and hope that your receivables arrive before your payables are due.
I don't think it's necessarily required that you have medical professionals on staff but my company always had at least a couple of RNs to work with doctors, hospitals, and nursing homes.
You need a good office support staff, a super sales staff that keeps the customers coming in (good luck with that one), skilled service techs with winning personalities who know what they're doing (ditto) and possibly an equipment repair person, a warehouse person, etc., etc., etc.
In my opinion there are easier businesses to operate, but the folks I've known in the DME trade generally enjoy what they do.
OCO
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harikarishimari
- Posts: 70
- Joined: Thu Dec 15, 2005 6:22 pm
- Location: NV
AH! JCAHO, now that is good objective information. Now I know where to look. I found the book: http://www.jcrinc.com/publications.asp? ... &return=77OwlCreekObserver wrote:I would expect that at least some states have licensing requirements. In most cases you'd have to pass periodic JACO (Joint Commission on Accreditation of Healthcare Organizations) inspections, which can be a bit of a hassle.
That should make interesting reading.
THANKS OCO !
Seek counsel of him who makes you weep, and not of him who makes you laugh.
6 posts
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