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 medical billers and coders are catering to physicians and providers in Nebraska in all major cities in Nebraska such as Omaha, Lincoln, Bellevue, Grand Island and Kearney.
With HIPAA regulations and changes in the reimbursement strategy across US, our medical billers and coders use appropriate solutions to keep your practice updated. They maximize your office efficiency by cutting costs and improving your bottom line. Some of the services where our medical billers and coders have shown proficiency are:
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Patient demographics and charge entry
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Insurance Verification
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Claim submission and follow up
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Payment posting
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Account receivables management
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