DME billing is known to be a tiresome process because of the various complications and dependencies that come with it. Moreover once claims are filed, the process of tracking and ensuring timely follow-ups can be very time consuming. Added to this, although disruptive but helpful ICD-10 coding system has led to a series of changes which has led to increase in investment in terms of staff training and IT infrastructure investment. Further, the increased scrutiny on the coding and billing errors, has increased the stress on the core section of the billing process- the billers and coders, which in turn leads to decreased productivity causing reduced cash flows which impacts the Revenue Cycle.
However, if the DME billing process is streamlined, hurdles identified, thorough knowledge of payer guidelines are imbibed, can help reduce dependencies and turnaround time, especially in the claims department. Leveraging domain knowledge expertise and maintaining compliance to HIPAA rules and regulations, maintain all records and audit process, goes a long way in reducing turnaround time and improving the Revenue Cycle Management process
Focus on specific DME billing sections, as mentioned below will not only help the DME billing process to reduce turn-around time and improve cash flow, but a more positive impact on the RCM process will be visible within a short time
- Front office: Verification and eligibility of patient demographics is essential. Minor mistakes can cause claim denials which leads to going through the entire cycle again. Payer guidelines of every patient who comes in needs to be vetted to be able to determine the kind of coverage available, especially, with respect to the use of DME
- Claims Submission: Setting up the IT infrastructure is essential as CMS has now made submissions to be made online. Electronic claim submission comparatively not only maximizes the claims processing efficiency but also helps to transmit information quickly and accurately. This process should also help meet compliance, help efficient documentation and improve claims accuracy thereby leading to submission of clean claims to the payer.
- Accounts Receivable: The most crucial component of DME billing process. Follow up on pending claims, initiate collection, analyze the reasons for the claims denial, track outstanding receivables ensures that maximum revenue is collected.
With a streamlined DME billing process integrated with minimum of technology and a maximum of knowledge by the medical billers and coders, your DME practice can hope to see positive impacts on your Revenue Cycle Management process, leading to faster and more efficient turnaround times and increased cash flows.