DMEPOS Network Managers: Applying to the Manager, Not the Plan

When a DME supplier wants to serve a health plan's members, the obvious move is to apply to the plan. Sometimes that is right. But some plans have handed the DMEPOS benefit to a separate company that runs the supplier network for them, and in that case the plan's own provider enrollment team will not contract a DME supplier at all. Knowing which arrangement you are dealing with saves months.

What does a DMEPOS network manager do?

A network manager stands between the plan and the suppliers. The clearest published description we have found is Blue Cross Blue Shield of Michigan's FAQ for DMEPOS providers, revised April 2026. It says Northwood, Inc. "administers and manages all aspects of durable medical equipment, prosthetics and orthotics, and medical and diabetes supplies (or DMEPOS). This includes managing the supplier network (provider contracting and provider management), prior authorizations, provider appeals and member services, and paying claims."

In other words, the manager picks the suppliers, decides what is authorized, and sends the payments. The plan sets the benefit; the manager runs it.

How does the Michigan arrangement work in practice?

The BCBSM FAQ describes two levels of arrangement for Michigan members:

• Preferred. For Blue Cross commercial fully insured groups and individual members, Northwood is the preferred provider; members who go outside it may pay more out of pocket.
• Exclusive. For Medicare Plus Blue, BCN commercial and BCN Advantage members, for dates of service on or after January 1, 2024, "Northwood is the exclusive provider. These members are required to obtain DMEPOS through Northwood."

The program does not apply to self-funded groups, members living outside Michigan, or certain Medicare supplement and complementary products. Northwood-contracted suppliers must get Northwood's prior authorization for DMEPOS, including changes in quantity, frequency or modality, before they dispense. And the supplier types covered are broad: durable medical equipment, medical supply, pharmacy providers who distribute or dispense DMEPOS, orthotics and prosthetics, oxygen and respiratory, mobility, sleep, diabetes supplies (including insulin pumps), speech-generating devices, breast and ocular prosthetics, and wigs.

For a supplier, the takeaway is simple: to serve those members, apply to Northwood. The FAQ says DMEPOS providers can call Northwood's Provider Relations department or apply online through Northwood's provider application website.

Do other plans use managers?

Northwood's own provider page lists provider materials for other health plans as well, including Boston Medical Center HealthNet Plan and WellSense Health Plan, and Security Health Plan of Wisconsin. The arrangement differs by plan and product line, and it changes when contracts change. Do not rely on a list you found online, including any you might expect from us; confirm with the plan for the specific product (commercial, Medicare Advantage, Medicaid managed care) and the state.

How do you find out who contracts DME for a plan?

1. Check the plan's provider manual or DME page. A plan that carves out DME may say so there and name the manager.
2. Check member benefits. The BCBSM FAQ tells providers to check benefits through the plan's provider portal to see whether a service is managed by Northwood.
3. Ask referral sources. Physician offices that order from you will know where the plan sends their orders.
4. Call provider relations and ask specifically: "Who contracts durable medical equipment suppliers for this product in this state?"

What will a network manager ask for?

Expect the same core file a plan would want, often with more emphasis on product categories and service capability: Medicare enrollment and PTAN, accreditation covering each product line, state licenses where you deliver, insurance, ownership disclosures, and your service area and hours. Managers that also handle prior authorization will train you on their own request process and documentation rules. Because they pay claims too, records that match PECOS and NPPES exactly avoid payment problems later.

Why can a manager change what you can supply?

Because the manager and plan can route specific products elsewhere. The same BCBSM FAQ says that, for Medicare Plus Blue and BCN Advantage members, CGM products must be obtained from a participating network pharmacy for dates of service on or after October 1, 2024, with an exception for UAW Retiree Medical Benefits Trust members. Commercial members with both medical and pharmacy coverage through the plan can get CGMs from a DME supplier or a network pharmacy. A DME contract with the manager does not guarantee every product line is open to you for every member group. Read the product rules before you count the revenue.

Is this the same as Medicare competitive bidding?

No. Competitive bidding is Medicare's own program for Original Medicare, run by CMS through the Competitive Bidding Implementation Contractor, with contracts awarded by bid. A network manager is a private arrangement for a health plan's members. Both can narrow who gets paid for a product, and a supplier in CGMs or orthotics may face both at once. See Round 2028 competitive bidding.

Who handles the application?

Network manager and health plan applications are credentialing work, handled by our sister company, White Glove Credentialing; their guide on how to get on insurance panels covers what reviewers look for. Our part is making sure what the manager checks is solid: Medicare enrollment, accreditation scope, state licenses and Medicaid enrollment. A $149 DMEPOS Readiness Review checks those against the product lines you want to supply. No one can promise a manager or plan will contract you. See getting into commercial DME networks for the wider picture.