INTEGRATED CARE MANAGEMENT AND QUALITY IMPROVEMENT. KePRO’s Service Authorization Process for Durable Medical Equipment . WY DOH/ KePRO Service Authorization Process Durable Medical Equipment . Overview of Service Authorization Process Information needed for a Request. 2.
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KePRO’s Service Authorization Process for Durable Medical Equipment
Requests may be submitted via:
From CMN/ DMAS 352 Certificate of Medical Necessity
Please include the following clinical information :
For Each Item Requested:
–Reason the Equipment is Needed
This information assists the reviewers in further assessing the patient’s condition.
InterQual® Durable Medical Equipment, and for HCPCS Codes not covered under McKesson InterQual® theWyoming Medicaid Rules, Chapter 11, Medical Supplies and Equipment are used.
Check the Wyoming DOH Medicaid Memos and Manuals online at: http://wyequalitycare.acs-inc.com/manuals/Manual_DME.pdf
DME Medical Supplies & Equipment Manual