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Durable Medical Equipment

Kaiser Permanente DME/P&O department is responsible for administering Durable Medical Equipment, Prosthetic and Orthotic as well as Softgoods benefits for our members. The department is dedicated to providing consistent and equal administration of benefits to all members who meet the coverage and clinical guidelines.

Our Mission

 

To provide our members with the right equipment or supplies at the right place, at the right time, with optimal service.

 

Definitions

Durable Medical Equipment (DME) is defined as an item that can withstand repeated use, is primarily and customarily used to serve a medical purpose, generally not useful to a person in the absence of an illness or injury and is appropriate for use in the home. Examples of DME include oxygen, nebulizers, canes, crutches, wheelchair, etc.

Prosthetic Devices (External) are devices required to replace all or part of an organ or extremity, but only if they also replace the function of the organ or extremity. An example of a prosthetic device is a lower limb prosthesis (artificial leg).
Orthotic Devices (External) are rigid and semi-rigid devices required to support or correct a defective body part. An example of orthotic device is a rigid back brace.
Soft goods fall under the following category of supplies: wound care, ostomy, urological and incontinence supplies.

Coverage

Coverage is dependent on a members benefit package, medical necessity, and limited to the standard item or equipment that meets the member’s medical need. Equipment or supplies must be prescribed by the appropriate plan physician. Once prescribed, orders are electronically sent to the DME/P&O department where it is processed. If the item(s) is(are) approved, an authorization is sent to the vendor who contacts the member to arrange for delivery.
Members are responsible for paying any applicable co-payments, coinsurance, and/or deductibles directly to the vendor, at the time of delivery. Any item received without authorization will be the members responsibility.

DEPARTMENT CONTACT
(855) 80KPDME or (855) 805-7363

Hours of Operation:
Monday –  Friday: 8:30 am — 6:00 pm
Saturday: 8:30 am — 5:00 pm