BOC-CDME study plan

Map every required element of a DME claim (patient info, provider identifiers, ICD-10 and HCPCS codes, modifiers, units, diagnosis-to-equipment linkage) into a one-page checklist you build yourself

Explain in writing how Medicare fee schedules, allowable amounts, and patient responsibility (deductible, coinsurance) interact for a standard item

Distinguish documentation requirements for a face-to-face encounter, a written order prior to delivery, and a proof of delivery

Identify the top five reasons DME claims are denied and state the corrective documentation for each

Work through at least 20 practice scenarios converting clinical notes into correct HCPCS codes, modifiers, and unit counts

Compare capped-rental, purchase, and lease arrangements and write the billing timeline for each across a 13-month example

Build a table of common modifiers (e.g., right/left, repair, replacement, upgrade) with the scenario that triggers each

Draft a patient-facing explanation of coinsurance and rental versus purchase in plain language

Classify at least 25 common DME items into categories (mobility, respiratory, support surfaces, ostomy/urological, diabetic supplies) with their typical HCPCS code families

Describe the clinical purpose, contraindications, and fitting considerations for wheelchairs, walkers, CPAP/BiPAP, oxygen concentrators, and hospital beds

Explain the difference between durable medical equipment and prosthetics/orthotics/supplies for coverage purposes

Trace the lifecycle of a device from initial fitting through maintenance, repair, and replacement

Demonstrate (in writing or role-play notes) a patient intake that captures clinical need, insurance, and functional goals

Practice explaining device setup, cleaning, and troubleshooting for three device types in plain language

Identify red flags that require escalation to a clinician or respiratory therapist during a patient call

Draft responses to five common patient objections or concerns about equipment use

Build a simple operating budget for a small DME company covering inventory, staffing, delivery, and billing costs

Explain how inventory turnover, rental asset utilization, and accounts-receivable days affect cash flow

Outline the workflow from order intake to delivery to billing to collections, naming the responsible role at each step

Identify key performance indicators a DME manager should track monthly and how to calculate each

Summarize the accreditation, licensure, and supplier-enrollment requirements that apply to a DME business

Describe fraud, waste, and abuse risk areas in DME billing and the compliance steps that mitigate each

Draft a short internal compliance policy covering documentation integrity and billing review

Explain HIPAA obligations specific to DME delivery, patient contact, and records retention

Analyze at least five ethical dilemma scenarios (e.g., pressure to bill for undocumented equipment, upselling) and state the correct action and rationale

Describe the appeals process for a denied claim from redetermination through higher levels of review

Design a customer-service standard covering response times, delivery windows, and complaint handling

Practice a difficult conversation with a patient about a coverage denial

Complete a timed 100-question mixed-domain practice exam and score it by domain

Review every missed question and write the underlying rule or fact it tested

Re-drill your three weakest areas using your own week-by-week notes and deliverables

Build a one-page pre-exam summary sheet of formulas, code families, and compliance rules