Docs / Working cases

Creating a case (fields explained)

Patient

Patient name — as it appears on the Medicare card and in the clinical record; consistency across documents is itself a Medicare requirement the checklist verifies
Medicare ID (MBI) — the 11-character Medicare Beneficiary Identifier (like 1EG4-TE5-MK72). AffirmDME validates the CMS format as you type; dashes optional
Sex and mailing address — required by the PA portals (CMS-1500 fields 3 and 5); you can add them at creation or later via Edit case — the checklist tracks them either way

Name and NPI — the ordering prescriber. The 10-digit NPI is validated against CMS’s NPPES registry live, catching typos before they poison the case
Previously used prescribers appear in a picker so repeat referral sources are one click

HCPCS code + description + quantity — one line per ordered item; duplicate codes on one case are rejected
Length of need (LON) — months, for rental items (1–99, where 99 = lifetime). Missing LON on a capped-rental item is one of the most common checklist failures

The declared HCPCS codes decide which equipment-specific requirements the checklist applies — declare what’s actually being ordered.

Payer — Medicare FFS today
Location — picks the PTAN this case bills under; jurisdiction and DME MAC follow from it
Priority / submission type — standard vs expedited; initial vs resubmission/appeal (resubmissions ask for the prior UTN — the checklist enforces it)

On pay-as-you-go, your first production case asks for a card before it’s created — see how pricing works. Sandbox cases never do.