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.
Our billing services in Indiana have been active for several years. Our pool of expert medical billers in Indiana specialize in almost all the specialties and are available in major cities like Indianapolis, Fort Wayne, Evansville, South Bend and Gary. They have been providing expert medical billing, consultation, medical coding as well as practice management services to many of the practices located in these cities. Their expertise extends across the following service:
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Physician credentialing
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Electronic and paper claim submission
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Coding with CPT, ICD-9 and HCPCS codes
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Efficient A/R receivables management
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Customized monthly financial report
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Along with 100% HIPAA compliance
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