The Challenge
As the population ages and care moves to the home, reevaluating your DME benefits management strategy is paramount
When members are sent home without identifying the appropriate resources to support them, such as durable medical equipment (DME), it could lead to additional sub-optimal health outcomes and higher costs due to:
- Delayed facility discharge
- Lack of supplier coverage, reliability, and competitive pricing
- Unnecessary hospital readmissions
- Delayed healing time and reduced quality of life
- Claims payment management challenges
- Fraud, waste, and abuse
Adopting a holistic, integrated DME solution with a single point of care platform can make it easier to support healing, and drive better health outcomes by:
- Simplifying authorization, ordering, and management of DME for providers.
- Leveraging a network of quality providers for timely delivery, set-up, and support.
- Effective Utilization Management and credentialed provider networks contribute to cost management.
- Ensuring payment integrity and identification of waste and abuse.
Program Results
Our Approach
Modernizing DME with a member-centric experience
CareCentrix has collaborated with Optum to redefine DME benefits management. DME Navigator streamlines the entire process from ordering to delivery and payment, enhancing efficiency and user-friendliness. Our integrated end-to-end solution provides real-time insights, lowers the cost of care, and improves service quality, benefiting clinicians, members, and suppliers.
The CareCentrix Value
Together with Optum, our comprehensive solution, DME Navigator:
Gets the right equipment
during service selection, an EHR (Electronic Health Record) integrated digital DME ordering platform showcases our credentialed in-network suppliers that have been evaluated on service quality, accessibility, and cost effectiveness.
For the right patient need
using integrated evidence-based criteria, streamlining utilization management (UM) processes, and providing transparency on order decisions at the point of care.
At the right time
with streamlined digital processes to enhance patient communication, order tracking, and reliable on-time delivery, minimizing delays or missing supplies.
To drive consistent cost savings
through upstream claims editing and pricing using negotiated, competitive rates.