CPB Certified Professional Biller Certification Practice Exam

What is the function of DMERC?

1. Delivering medical equipment to hospitals

2. Processing claims for durable medical equipment

3. Durable medical equipment regional carriers

4. Distributing medical supplies for clinical trials

The correct answer is: Durable medical equipment regional carriers

The function of DMERC, which stands for Durable Medical Equipment Regional Carriers, is primarily focused on the management of claims for durable medical equipment (DME). DMERCs are specifically designated by Medicare to handle the claims submitted for DME, ensuring that the procurement, usage, and reimbursement adhere to regulatory standards and guidelines. They play a crucial role in reviewing and processing these claims to determine the appropriateness of reimbursement based on established criteria. This process includes assessing whether the equipment is medically necessary and whether it meets the Medicare coverage requirements. By focusing on processing claims, DMERCs help streamline the reimbursement process for healthcare providers while safeguarding against inappropriate billing for DME. In contrast, the other options do not accurately represent the core function of DMERCs. For example, delivering medical equipment or distributing medical supplies for clinical trials is outside the scope of what DMERCs do. Therefore, identifying DMERC specifically as regional carriers responsible for processing claims clarifies their vital role in the healthcare billing ecosystem.