UC DME Program 2026

TLC earns Trust & Loyalty by exhibiting our Commitment to your success and by delivering Tender Loving Care with every interaction. We understand it is a blessing to have the opportunity to be of service and are grateful for your consideration.

TLC specializes in Urgent Care. Our customizable program addresses the needs of the smallest independent operator to the largest national organization. Our program improves clinical outcomes, enhances patient satisfaction, & increases financial well-being.

TLC solutions include extended terms, factory direct pricing, EMR customization, updated HCPCS codes & fee schedules, optimized revenue from reimbursement, offsets 100% of product cost related to global & unpaid patient AR, provider training & patient education, comprehensive reporting, all crafted to enhance your DME success.

Urgent Care / Work Comp Products

TLC products are best in class quality & functionality, are designed to address the unique urgent care work comp injuries and indications commonly treated in urgent care/work comp, are PDAC approved for higher levels of reimbursement from all insurances, are used by Ortho, and are not sold on Amazon!

Inventory Consignment Terms

TLC offers factory direct pricing. All startup inventory is consigned with N180 terms. Reorders are N90. This allows generation of reimbursement revenue before invoices are due. All products are guaranteed 100% returnable no restrictions. We even buy back competitor’s products, and donate to charity.

Data Driven Reimbursement Solutions

Using your ICD10 & CPT information, we quantify your actual vs. potential DME ancillary revenue, customize your EMR with current HCPCS codes & fee schedules, collaborate with your RCM team to ensure no charting or billing errors, and when you are not reimbursed (global, CMS, unpaid patient AR), credit 100% of product cost.

Clinician Training & Patient Education

We offer comprehensive training via virtual or onsite demonstrations supported by tutorial & animated videos addressing indications for use, application instructions, presenting to the patient, and documentation. These tools enhance knowledge for clinicians & patients, while promoting your orthopedic injury management protocols.

Compassionate Care & Financial Hardship

Patients ask “will my insurance pay for this”, what will this cost me”. When insurance will not cover the cost of the orthopedic device, we will. This allows your clinicians to dispense based on medical necessity, offering the best patient care possible, removing the barriers created by lack of coverage, with little to no cost for the patient!

XO Back LSO Cryo

Indications: Lower back pain, strains and lower back muscle spasms

PDAC Approved HCPCS Code: L0642 & L0651

XO Boot Pneumatic

Indications: Moderate to severe ankle sprains, stable foot/ankle or tib/fib fractures and foot or toe injuries.

PDAC Approved HCPCS Code: L4361 & L2840

XO Sling Arm/Shoulder XO Thumb Orthosis

Indications: Immobilization of the shoulder/arm, injuries or instabilities of the shoulder/arm, dislocations and subluxations

PDAC Approved HCPCS Code: L3670

Indications: Sprains and strains, scaphoid injuries, carpal tunnel syndrome, gamekeeper’s thumb, and de quervain’s syndrome

PDAC Approved HCPCS Code: L3809 & L3995

XO Knee ROM Cryo

Indications: Sprains or strains of the knee, medial and lateral instabilities,and soft tissue injuries of the knee.

PDAC Approved HCPCS Code: L1833 & L2937

XO Wrist Orthosis

Indications: Sprains and strains, carpal tunnel syndrome, and distal/ radial fractures.

PDAC Approved HCPCS Code: L3809 & L3995

DME Billing Success Trends

Global Billing Service Program

1. Once the diagnosis is established, determine which DME product to prescribe/dispense and apply to the patient.

2. Complete DME Prescription & Delivery Ticket Form

a. Section 2 DME Prescribed (select product(s) dispensed)

b. Section 3 DME Product Sticker (place DME stickers on form)

c. Section 4 Patient Info (Name, DOB, Sex, Signature, Bill To)

d. Section 5 Provider Info (Dx Code, Provider Name, NPI Sign)

3. Submit the completed Delivery Ticket with Chart Notes & Patient Demographics from your EMR.

a. Email order-sb@tlcmedical.com

b. Save a copy for your records

4. If you have any questions or need any support, please contact:

Christine Newman VP of Operations

DME Prescription & Delivery Ticket

SECTION 1: FACILITY INFORMATION

Facility Name: Ph:

SECTION 2: PRESCRIBED DME INFORMATION

Please place product sticker(s) here:

SECTION 3: PRODUCT STICKER

Diagnosis or Dx Code:

Provider Name (please print):

Provider Signature (no stamps):

Patient Name (print):

SECTION 4: PROVIDER INFORMATION

SECTION 4: PROVIDER INFORMATION

NPI#:

Date of Order:

Length of Need:

SECTION 5: PATIENT INFORMATION

Patient Date of Birth:

Right to Choose a Supplier: I understand I may choose any supplier for my durable medical equipment (DME). The clinic, Medtech Enterprises, LLC, or an affiliated third-party administrator (TPA) may provide or coordinate my device for convenience. I am not required to use any specific supplier and may request a referral to another provider. I have chosen to receive my device voluntarily, without pressure or obligation.

Home Environment & Safety: I received my prescribed device(s) and instructions for proper use and home safety, including guidance on pathways, personal limits, and wearing techniques.

Insurance Billing & Financial Responsibility: Medtech Enterprises, LLC, the clinic, and/or TPAs may bill my insurance when applicable. If none are contracted with my plan, or if coverage is denied, I agree to pay for the device. I have been informed of my supplier choice and understand I am responsible for any uncovered or non-covered costs.

Proof of Delivery & Warranty: I confirm receipt of my device(s) and understand it is covered by a 90-day manufacturer warranty against normal-use defects. Misuse or alteration voids this coverage. Returns of unworn devices within 14 days will be credited within 30 days. I am satisfied with the fit and instructions provided. Text & Electronic Communication Consent: I consent to receive texts, calls, or electronic messages from the clinic, Medtech Enterprises, LLC, or authorized partners regarding my device, insurance, or billing. Standard rates apply. I may opt out anytime by replying “STOP.” Consent is not required for care.

HIPAA Notice: I acknowledge receipt of the Notice of Privacy Practices describing how my protected health information (PHI) may be used for treatment, payment, and operations. A copy is available at patientcare@medtechortho.com.

Supplier Standards: I acknowledge access to the Medicare DMEPOS Supplier Standards available at: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/DMEPOSEnrollment

Patient Signature: (or auth rep)

Print Name of Authorized Rep:

Relationship to Patient:

Date of Delivery:

SECTION 6: SUBMISSION

Please fax or email this completed form. Submission MUST INCLUDE Patients Demographics and Chart Notes

TLC DME Purchase Service Agreement

Inventory Terms: Initial inventory will be processed and shipped to each location with N180-day terms. You have a full six months to evaluate all products, gauge patient satisfaction, and receive reimbursement before any payment for the startup inventory is due. Reorders are N90 day terms. Start-up order details are included in Appendix A. You can return anything at any time for any reason for full credit

Termination of Agreement: Termination of services & purchases requires a 60-day written notification. If a change in ownership of your clinics takes place the new owners will assume responsibility for all outstanding balances. Any TLC unused, non-logoed products in resalable condition may be returned.