For adjusters & case managers
Documentation-first DME for your NF and WC claims
A complete file before fulfillment, clear status updates, and delivery confirmation on file. Local fulfillment and a documented paper trail mean fewer disputes and less rework on the claim.
The short answer
How does CityDME handle DME billing for no-fault and workers’ comp claims?
Documentation-first: we assemble a complete file — prescription, claim details, and required authorizations — before fulfillment, so there are fewer disputes downstream. You get status updates and delivery confirmation on file. Product selection stays cost-conscious within the prescribed order and payer requirements. A prescription is always required, and we bill the carrier where eligible.
Service standards
What we do to avoid rework
Documentation-first billing
We assemble a complete file — prescription, claim details, and any required authorizations — before fulfillment. A complete file up front means fewer disputes and less rework downstream.
Status transparency
You get clear status updates on where a referral stands, with delivery confirmation on file. We provide documentation of the equipment timeline — whether it’s a back brace, a cold therapy unit, or a CPM rental — with cost-conscious product selection within the prescribed order and payer requirements.
Delivery confirmation on file
When eligible, in-stock equipment is delivered, set up, and fitted locally, and the delivery confirmation is kept on file — so the record shows what was provided, when, and to whom.
- File-first
Complete documentation before fulfillment
- On file
Delivery confirmation kept on record
- WC + NF
New York claim paths we handle daily
- 5
Boroughs served from Brooklyn
Fewer disputes by design
The cheapest claim is the one that doesn’t come back. A complete file before fulfillment — prescription, claim details, and required authorizations — plus delivery confirmation on file gives you a clean record and fewer downstream disputes.
- File-first
Complete documentation before fulfillment
- On file
Delivery confirmation on the record
- WC + NF
New York claim paths handled daily
The exchange
What you send, what goes on the record
Four things from your desk, four things back on the claim record — every time, on every referral. A prescription is always required before equipment is supplied.
| What your desk sends | What the desk returns |
|---|---|
| The referral with claim details | Next-business-day acknowledgement |
| The prescription, if in hand | A complete file assembled before fulfillment |
| The claim number | Clear status updates as the order moves |
| The carrier and adjuster contact | Delivery confirmation on file |
Send or check a referral
One form for the whole intake. Pick “Adjuster” as who’s referring, add the carrier and claim details you have, and we’ll confirm the rest. A prescription is always required.
Adjuster FAQ
Questions from claims professionals
- How does CityDME handle DME billing for no-fault and workers’ comp claims?
- Documentation-first: we assemble a complete file — prescription, claim details, and required authorizations — before fulfillment, so there are fewer disputes downstream. You get status updates and delivery confirmation on file. Product selection stays cost-conscious within the prescribed order and payer requirements. A prescription is always required, and we bill the carrier where eligible.
- How do you reduce disputes and rework?
- We assemble a complete file — prescription, claim details, and required authorizations — before fulfillment, and review the prescription and claim details up front. Catching gaps before delivery means fewer disputes downstream.
- Can I get status updates and delivery confirmation?
- Yes. We provide clear status updates on where a referral stands and keep delivery confirmation on file, so the claim record shows what was provided and when.
- How do you keep costs controlled?
- Product selection stays cost-conscious within the prescribed order and the payer’s requirements. We work from the prescription and do not substitute outside what was ordered and what the claim allows.
- Do you submit the workers’ comp prior authorization?
- No. Workers’ comp DME PARs must be submitted through OnBoard by the Board-authorized provider who ordered the DME — DME suppliers are not eligible to submit PARs. We flag when a PAR is needed and tell the provider’s office what to submit.
- Is a prescription always required?
- Yes — a prescription is always required, and $0 out of pocket where the claim applies and documentation is complete. We bill the carrier where eligible.
Related: How it works, the referral page, workers’ comp DME, no-fault DME, or the desks for attorneys and providers.