[JMKRN]

First of many questions, I am sure. Still in research phase, but planning to start new DME in area. Something that I am not understanding ... planning to seek JCAHO accreditation, Medicare, etc., but confused about timing issues. Do I understand correctly that you must be operational prior to receiving accreditation? Is it possible to operate without accreditation & still bill Medicare? If not, should we expect to operate as a "cash-only" business until we can get our site survey, etc?

[JoeyGraham]

First you need your local and state business licenses. Since you're in Florida that means you've got to tango with AHCA - you have to be operational to receive your AHCA survey; however, you can't sell any HME until after you've successfully passed it. So you've basically got to pay someone to sit there in your office for a couple months until you pass your AHCA survey. I'm sure you could concurrently start the process of getting accredited by JCAHO (most expensive and ridiculous) or a different (preferable) accrediting body.

You will not be able to bill Medicare until after you get accredited, which could take as long as 6 months. So you will have a period of time after you've passed AHCA and before you've become accredited - during that time you can be a "cash" business and you can go after insurance contracts (though most require a medicare #) as well as bill insurance companies that don't require a contract.

The barriers to entry in the world of HME are pretty high and they're increasing. CMS recently passed legislation that will put a hold on all new provider #s, so you'll most likely be hit with that. Make sure you're cash heavy and ready to fund the business for the first year or more before you see an inkling of profits. My advice - don't open a new HME. Put your $$ into an industry where a small business has a chance of making a profit.

[ggroden]

Yes, you do need to be operational before the accreditation survey, and
cannot bill Medicare till accredited. You can bill for some other payers
depending on your area. Most of your business would probably be cash until
accreditation. I will be glad to talk further with you if you would like.
Joe Groden

Joe Groden
JG Consulting
(585)388-8824
(585)377-9158 fax
www.jgconsults.com