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.
Your practice can suffer with changing healthcare conditions and reductions in reimbursements can prevent you from retaining quality staff. At the same time maintaining the level of profitability for your practice can be quite a challenge.
Our Vermont medical billing professionals, with their exceptional expertise in billing and collections services can help you to streamline your daily operations as well as increase your practices’ expansion and find more time to deliver your patients with the highest degree of care. These Billers are present in almost all major cities of Vermont like Burlington, Essex, Rutland, Colchester, and South Burlington.
Our Billers are specialized in providing the following Medical Billing functions:
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Data entry of patient demographic
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Analysis of accounts receivables
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Aggressive follow ups on transmitted claims
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Tailor made practice management reporting
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Speedy eligibility verification
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