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.
Maximizing your office’s efficiency and cutting your costs are some of the priorities of our medical billing and coding specialists located in Texas. Like everything in Texas our database of Medical Billers and Coders is huge in texas, these billers cater to various specialties and software exposure.
With extensive medical billing knowledge coupled with their years of experience, they help providers and practices in and around the state to maximize their reimbursements and minimize their costs.
Our billing professionals are present in major cities in Texas such as Houston, San Antonio, Dallas, Austin and Fort Worth. Some of the services they provided are:
Data entry of all charges
Submission of electronic as well as paper claims to both primary and secondary insurers
Accurate ICD-9 and CPT code audits
Payment postings after receiving from insurance companies as well as patients
Excessively customized Monthly financial reports
Comparing payer fee schedules and updating your practice about it