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:
The need to establish the necessity of a DME device within a treatment episode
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.
Our Florida billing service can help you to increase your revenue with the reduction in the number of denied and unpaid claims. Our billers present in all the major cities like Jacksonville, Miami, Tampa, St. Petersberg and Orlando can provide you with less paperwork and more accurate medical claims to improve the efficiency of your practice. Here are some of the services which our billers have shown their proficiency in:
Claims are processed on the same day
Analysis of accounts receivables
Weekly as well as monthly reports on productivity
Analysis of codes and procedures on a regular basis
Review of fee schedules for updates