I worked in DME before going into an office setting. Let me tell you, it is really nice being able to say, "here's your script. Go to X-Y-Z and they'll take care of you and explain everything. They'll do a benefits investigation to see what your coverage is and they'll be able to tell you if you'll have any financial responsibility and whether or not your ________is covered with your insurance. You may have an out of pocket expense but they'll work that out with you."
That being said, DME billing is kind of a beast. Unless you are buying your own nebulizers from a wholesaler and retailing them outright. But if you want to be able to bill insurance companies for them, there's a monthly billing cycle involved and the product is "rented" for a full year before it is owned by the patient (unless that is strictly a CPAP machine rule - the rules are always changing). The forms for DME are different too. And they don't use CPT codes, they use HCPCS codes, so the code set is different. You'd likely need a Medical Supply Retail license and you'd have to see if your local health department requires you to have a sanitation program or something to that effect. And possibly clinical certifications. You may need a licensed respiratory therapist on staff to do the set-ups and patient training when dispensing a machine.
As commendable as it is that you're providing a courtesy to your patients, courtesy doesn't pay the bills.
I would do myself an favor and let the DME supplier handle it all since you don't get reimbursed for the time it takes to do the footwork.
Try contacting your local medical supply company, hospital organization or state health department and they may be able to point you in the right direction if you want to become credentialed and what the licensing process may be. I know in RI the process is rigorous, frustrating and the reimbursements are not worth the effort.
