Improve the network you have. Build the network you need.
The clinical and financial performance of a DME/O&P program depends on connected decisions: which vendors participate, how reimbursement is structured, which products are selected, and how complex utilization is evaluated.
ARCLYFT works with health plans, delegated entities, medical groups and other risk-bearing organizations to assess these questions, design practical strategies and support execution. Every engagement is tailored to the client’s network, population, data and priorities.
Four Connected Areas of Network Strategy
ARCLYFT can address one focused challenge or bring these areas together in an integrated network strategy engagement.
DME/O&P Focused Advisory
One question. One engagement. The same evidence and experience behind Network Strategy.
Not every DME/O&P problem calls for a full network strategy. Many clients come to ARCLYFT with a single, specific question—a vendor that isn’t performing, a fee schedule that no longer fits, a category of authorizations that keeps stalling. Focused Advisory engagements address that one question with the same market intelligence and operator-side experience, and scale into an integrated Network Strategy engagement only if you decide they should.
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Utilization and claims analysis for DME/O&P, with clinical, coding, and administrative insight to support your UM team’s review of complex requests. Advisory support only; coverage determinations remain with your medical directors.
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Assessment of how your current vendors are actually performing—access, service levels, responsiveness, reporting—and what to change, renegotiate, or replace.
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Reimbursement economics, fee-schedule strategy, and contract structure aligned with clinical and coverage guidelines, so the terms you sign reflect what your members receive.
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A board-certified prosthetist/orthotist’s perspective for payer medical directors on product appropriateness, clinical documentation, and the questions that distinguish a well-supported request from an expensive one.
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Program design, vendor-transition planning, benefit configuration, and the operating questions that sit between your network team, your UM team, and your finance team.
DME/O&P Product Category Expertise
Scope note: ARCLYFT Health's DME/O&P advisory services do not include power mobility devices, complex rehabilitative seating, or adaptive vehicle modifications.