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Tennessee, TN Durable Medical Equipment Billing Services

When it comes to Durable Medical Equipment (DME) reimbursement, the difficulty lies in the fact 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 that enjoy 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 Tennessee medical billers and coders have been helping local healthcare professional in and around the state for many years now. They all seem to have collected their knowledge with years of practice of dealing with local payers.

They work towards eliminating your outstanding accounts receivables and make your reimbursement process seamless. They have been catering to major Tennessee cities like Memphis, Nashville, Knoxville, Chattanooga and Clarkesville and are willing to travel to your clinic anywhere in Tennessee.

These proficient billers provide customized services to meet the requirement of your practices. Some of the services our professional medical billers can help you with:

  • Accurate and prompt verification of benefits
  • Scheduling appointments
  • Complete charge entry for claims
  • Posting Payment regularly
  • Electronic Claims transmitted through carriers or clearing house
  • Thorough audit before transmitting claims

Over the last few years gross charges denied have grown to 18%, based on estimation for US healthcare providers. This has made the physicians from Tennessee worry about denial ratio.

Consulting professionals or expert medical billers and coders to understand the major reasons for denials works well with busy physicians. Our Billers can consult with you for your accounts receivables and insurance follow-up by being an extension for your practice. Moreover they are also proficient in medical terminology, disease processes, anatomy and physiology, life cycle of an insurance claim, health care settings, health care payers, procedure and diagnosis coding from medical records, reimbursement systems, surgical procedures, facility billing, and medical practice management systems.

Value Our Tennessee Billers Bring:

Our medical billers and coders are experienced in insurance collections which can be a tedious job for someone who lacks experience in this area. They also understand how critical timely insurance collections are for the physician as well as the patient. By using EMR that is efficient our medical billers and coders are quick in patient statement processing which can be an increasing burden due to the rising demand for medical services. Our medical coders and billers at medicalbillersandcoders.com also have solid relationships with key insurance companies across the nation and state so that any delays or errors can be avoided when dealing with insurance matters such as claims denial and in revenue cycle management.

Billing and coding services provided by our billers and coders are a mix of specialized professionals with wide ranging skills such as insurance collections, patient statements processing, claims management, fee schedules evaluation, and the ability to establish effective relationships with patients and insurance companies and expertise with patient accounting software. With in-depth knowledge of the medical billing and coding and compliance of HIPAA guidelines, it would become easier for you to ensure that revenue and quality of patient services is not affected due to errors in medical coding and billing.

Their skills with Insurance eligibility verification and account receivables follow up, is the main reason for many Tennessee clinics to experience a growth of 20% in revenues with their Medical billing services.

Our Specialties :

Our billers and coders are specialized in various areas such as Optometry, Family Practice, chiropractic, OB Gyn, Physical Therapy, oncology, Pediatrics, urology, and Hospitalist Billing. All the medical billers and coders at medicalbillersandcoders.com are familiar with ICD9 and CPT Coding which make them preferable choices for physicians. Many of our medical billers and coders provide value added services to offer through specialized services like evaluating fee schedules, helping you prepare online super bills and diagnosing major reasons for denials.

Our Software Experience :

With the implementation of efficient EMR software our medical billers and coders ensure a paperless, time saving, and efficient medical billing system. The EMR software which they are already trained on include Medisoft, Misys Tiger, Eclinicalworks,Advance MD, GE Centricity, and Altapoint. Using these software would not only save time but also assist you in handling the increase in demand for your services as a health care provider. The Practice Management software that we provide in addition to the value added services mentioned above ensures that physicians in Tennessee are able to keep up with the healthcare IT sector reforms and improvements.

Problems Tennessee Physicians Face :

Physician shortage is a huge problem in Tennessee and increasing number of patients in the near future would mean requirement of experienced and skilled medical billers and coders. Moreover, lesser claim denials may be expected due to the health reform which makes it imperative that you have a flawless and professional team of medical billers and coders. Our expert medical billers and coders ensure quality revenue cycle management service across almost all the counties and cities in Tennessee and not just big cities such as Memphis, Nashville, Knoxville, Chattanooga and Clarkesville.

Outsourcing to MBC:

MBC can simplify the situation for you:

  • Our team of billers and coders have years of experience in handling DME documentation starting from the beginning to the end of a medical episode.
  • Our billers and coders can help you develop a physiological description of the client’s disease, injury, impairment, etc, and other requirements, including videos and photographs to demonstrate the client’s impairments and ability to use the equipment.
  • Our DME billers and coders can help you with the entire set of reimbursement administrative activities starting from accurate identification of the instances eligible for reimbursement through preparation of claims to submitting them.

Depending on the size and need of your set up, you can choose any service model you want. If you are an independent physician without an in-house team of billers and coders nor any need for it, you can choose our outsourced billing and coding services and we would take care of the complete range of billing and coding responsibilities for you, including preparing claims using appropriate codes and other medical details, submitting them and following up with insurance authorities for their timely reimbursement.

If you are a bigger set up with an in-house team of people handling billing and coding for you who are struggling with long-drawn procedures, bumbling software applications and medical and procedural intricacies leading to rejected claims, all your in-house operations need is streaming up of your billing processes. Our Revenue Cycle Management (RCM) consulting model can help you. We will conduct a thorough study of your operations and strip out cumbersome processes and replace them with leaner and efficient ones, identify where your in-house staff need training and help train them and recommend appropriate software applications that will be easy to use, compatible with your environment and will help you be in Medicaid and Medicare compliance more easily and seamlessly than the ones you have today.

Benefits to Our Physicians:

Through both outsourcing and consulting services, we have helped physicians, hospitals and nursing homes across all states of the US improve their revenues and time that was spent earlier on nonmedical activities. We have been able to achieve this by improving the number of reimbursed claims, ensuring their timely payment and sparing their staff nonmedical administrative activities.

Our success with DME claim turn around doesn’t just include reimbursement of fresh submissions but also resubmissions made following rejections. Our billers and coders are experienced enough to assess and address reasons for rejections and where possible resubmit claims and ensure their reimbursement by Medicaid and Medicare, helping healthcare providers avoid having to deal with an unresponsive and lumbering post-submission process which often gives them a hard time.

The highlights of our services have collectively helped healthcare providers overcome the problems associated with DME devices and concentrate on delivery of care.

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