We want to help you avoid denials when submitting durable medical equipment (DME) claims for UnitedHealthcare Community Plan members in Wisconsin.
To comply with Wisconsin Medicaid billing guidelines, effective Jan. 1, 2024, the number of days indicated on DME claims must equal the number of days within the dates of service (DOS) range. We will deny claims billed outside the calendar month.
Billing guidelines for rental and purchased DME claims
Rental DME must be ranged within the same calendar month per claim line
If the DOS range spans different months, this needs to be indicated separately on different claim lines
List “from” and “to” dates of service (DOS) on the claim
If the DME was provided on consecutive days, those dates may be indicated as a range of dates by entering the first date as the “from” DOS, and the last date as the “to” DOS
Please note the “to” DOS requirement does not apply to Medicare crossover claims.
Indicate only 1 specific DOS for each purchase, not a range of dates
You can, however, list 2 consecutive dates, such as June 1, 2023, to June 2, 2023
Here are examples of claims billed with “from” and “to” DOS, with the unit number equaling the days billed: