In DME, the same piece of equipment can often be treated either as a rental or a purchase, depending on the Payer’s rules and the Patient’s situation. Conceptually, there are two layers involved: the Item itself (what the product is) and the pricing/behavior (how it is billed over time).

The item answers: “What are we giving the patient?" (a concentrator, a hospital bed, or CPAP machine).

The pricing and related billing logic answer: “Are we billing this as a monthly rental, a capped rental that may eventually convert to ownership, or a one-time purchase?”

For a deeper understanding of different pricing models included in DME, visit our help article on Pricing Models in Billing for DME.

In Brightree, the way you set up an item tends to lock in whether it behaves as a rental or a purchase. If you choose the wrong behavior, you may need to delete and re-add items or use workarounds to change how they are billed. While switching an item from a rental to a purchase is simple in Brightree, switching from a purchase to a rental is complicated. You have to completely recreate the order and write off any Invoices accidentally created.

In NikoHealth, the product itself is neutral. Rather, the “rental vs purchase” behavior is driven by pricing and Invoice logic, not by the item definition. The same item can be billed as a rental or as a purchase, depending on:

This design gives you more flexibility when Payers change their rules or when a rental needs to convert to a purchase. Separating the physical product from its rental vs purchase behavior allows you to use the same item in different ways for different Payers, while keeping your product catalog clean and consistent.

For more information on pricing options for rentals in NikoHealth, visit our help article on Rental Price Options.

In NikoHealth, treat the item as the thing and decide rental vs purchase at the pricing/Invoice level. You can adjust there if needed. For more information on changing a rental to a purchase and a purchase to a rental, visit our help article on Common Invoice Actions.

You can start a rental on the Invoice and later convert behavior without rebuilding the item.

Rental billing continues even if you’re doing equipment exchanges or pickups; inventory actions don’t automatically kill rental streams.