When it comes to Durable Medical Equipment (DME) reimbursement the difficulty is that they don’t form a complete treatment episode but a part of it and their necessity for a treatment episode depends on the physician’s recommendation. This dependency makes reimbursement of DME incidents complicated necessitating additional paperwork to record and establish their necessity for a treatment episode.
Additionally, seen from a DME reimbursement standpoint, ailments are not covered by Medicaid or Medicare as such but only such ailments as are treated with the use of DME devices. Sleep disorder is a point in case. There are various sleep disorders but only such sleep disorders are reimbursed as are treated by the use of CPAP which enjoys insurance coverage under Medicaid.
If we simplify the above facts regarding DME from a reimbursement point of view, two deductions will spring up:
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The need to establish the necessity of a DME device within a treatment episode
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Knowledge of the devices that are covered
The second requirement is more complicated than it looks; its coverage eligibility is circumstantial. For example, a wheel chair will be covered only when used exclusively for a permanently disabled nursing facility resident and if not included in the nursing facility per diem rates.
The state of Alaska though considered far from the mainland states is still serviced by our Medical Billers and Coders with the same level of service and integrity. Our local Alaskan medical billing specialists with more than 15 years of experience cater to multiple medical specialties.
Their expert knowledge and skilled professionalism has had many physicians from across all major cities like Anchorage, Fairbanks, Juneau, College and Ketchikan concentrate more on patient care. These physicians can personally vouch for the medical billing experience of these billers in Alaska. You too can experience the same expertise with your billing process with their help across these medical billing functions:
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Eligibility verifications
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Electronic and paper claim submission
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Payment as well as adjustment posting
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Claims denial management
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Patient statement services
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