DME(Durable Medical Equipment)s are prescribed by medical practitioners for inpatient or outpatient use and needs to be approved by the patient’s insurance.
Why is it necessary to install the correct billing software, especially when you are in DME practice? Well, ensuring you are compliant at every step in your DME billing process is very essential to get your claims paid. Billing according to contractual requirements, local or national coverage determinations, meeting timely filling limits, etc are some of the basic requirements that you could meet and yet be denied a claim.
There are many more reasons than these pre-requisites- providing evidence of the medical necessity to justify payment received especially when and if audited, providing proof of delivery prior to being reimbursed by patient’s payer, are all part of the complex Revenue Cycle Management (RCM) system which needs to be streamlined.
And herein lies the greater complexity – the solution itself becomes the problem- which of the many billing software are appropriate for DME billing practice – so that one can track the completion of each step in the gathering and collecting of medical documentation for each claim?
We have taken 3 of the most commonly implemented DME billing software here
Features |
Practice Suite |
Bflow Solutions |
Provider Suite |
| Ease of Use | Friendly workflow dashboards | one-click access to everything | Real-time patient eligibility verification |
| Cloud-based | ✓ | ✓ | ✓ |
| Simplicity | ✓ | ✓ | ✓ |
| Reports | ✓ | ✓ | ✓ |
| Integration | ✓ | ✓ | ✓ |
| Compliance | ✓ | ✓ | ✓ |
| Customer Service | ✓ | ✓ | ✓ |
| Best Feature | Simplicity | Workflow specially designed for DME billing | ARI |
Practice Suite, Bflow solutions, Provider Suite are some of the popular solutions for DME billing. The features and benefits offered by these solutions are elaborated below:
Practice Suite comes with the following advantages:
- User-friendly workflow dashboards, calendars
- Single screen, intuitive charting, and patient documentation
- Fully Certified (Stage 2 ONC-ATCB Certified for Meaningful Use)
- The cloud-based solution allows the system to be accessed from any device
- E-Prescribing for over 70,000 nationwide pharmacies
- On the fly personalization features and flexible
- Smooth integration and ease of transition
- billing and coding processes greatly simplified
Disadvantage: This Suite comes but with the disadvantage of its usability for physicians in rural areas with poor internet connections.
Bflow Solutions: One of the recent entries but fast rising to the top
- Auto re-rentals, Auto payment posting, Auto refills
- Integrated patient document imaging
- One-click access to everything which makes navigation easier
- Same day batch transactions
- Cloud platform enables access from any location/device
Dis-advantage: Reporting still undergoing modification and testing
Provider Suite features:
- Real-time eligibility verification
- Patient eligibility checks
- Maintain patient payment history
- Integrates well for practice management
- Good value for money
Disadvantage: The occasional challenge with EMR interface integration
About Medical Billers and Coders
We are catering to more than 40 specialties, Medical Billers and Coders (MBC) is proficient in handling services that range from revenue cycle management to ICD-10 testing solutions. The main goal of our organization is to assist physicians looking for billers and coders.
FAQs: DME Billing and Software Solutions
1. What is Durable Medical Equipment (DME)?
Durable Medical Equipment (DME) refers to medical devices prescribed by healthcare providers for patient use, either inpatient or outpatient, and must be approved by the patient’s insurance.
2. Why is proper billing software essential for DME practices?
Proper billing software ensures compliance with insurance requirements, timely filing, and accurate claim processing. It helps track every step in the DME billing process and reduces the chances of claim denials.
3. What are common reasons for DME claim denials?
DME claims may be denied due to incomplete medical documentation, missing proof of delivery, failure to meet filing deadlines, or issues with coverage determinations.
4. What are the top DME billing software options?
Popular DME billing software includes Practice Suite, Bflow Solutions, and Provider Suite, each offering features like cloud access, compliance tracking, and patient eligibility verification.
5. What is the main advantage of Practice Suite?
Practice Suite offers user-friendly workflow dashboards, easy charting, and cloud access, making it an efficient solution for DME billing. However, it may face challenges in rural areas with limited internet connectivity.
6. What makes Bflow Solutions stand out?
Bflow Solutions is known for its one-click navigation, auto payment posting, and cloud access. It is a rising solution for DME billing but still undergoing improvements in reporting features.
7. How does Provider Suite benefit DME practices?
Provider Suite provides real-time patient eligibility verification, maintains payment histories, and integrates well with practice management systems. However, it can occasionally face integration issues with EMR systems.
8. Why is medical necessity documentation important in DME billing?
Providing documentation that proves the medical necessity of DME is critical for justifying payments, especially in the case of audits, to ensure reimbursement from insurance providers.
9. What services does Medical Billers and Coders (MBC) offer?
MBC provides a range of services, from revenue cycle management to ICD-10 testing, assisting physicians in managing billing and coding across over 40 medical specialties.
