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DME Discharge

The following information will be needed for a DME discharge;

Dr.’s Prescription with the following information needed prior to delivery:
Patient’s Name and Address
Diagnosis (specific to equipment)
Type of equipment
Equipment is to be used in Patient's Home. (Required by Mass Health)
Dr.’s Name, Address
Dr.’s Signature
Date

Any Rehab notes showing equipment use.                                             

   
 


Need a Local Provider?

Life Supply Corporation • 11 Veterans Drive, Chicopee MA, 01022 • 413-593-5555
Life Supply Home Medical • Physicians Office Center, 299 Carew Street • Springfield MA, 01104 • 413-737-5555
Diversified Medical Equipment Services • 143 Mill Street • Leominster, MA 01453 • 978-537-8707


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