PECOS Enrollment: Guide to Medicare Provider Enrollment (Avoid the 15 Most Common Errors)

PECOS Enrollment Guide Every day, healthcare providers lose thousands of dollars in Medicare reimbursements due to preventable PECOS enrollment errors. A single mistake in your Provider Enrollment, Chain, and Ownership System (PECOS) application can delay your Medicare billing privileges by weeks or even months, creating a revenue crisis for your practice. Whether you’re enrolling for […]

Successful 3 Levels of Appeals for Higher Collection in DME

Higher collection in DME for efficient billing procedures is essential in the healthcare industry to ensure financial stability. One aspect that needs a specialized understanding is DME medical billing. DME (durable medical equipment) contains devices and equipment prescribed by healthcare professionals to assist patients in their recovery. Durable medical equipment refers to things or services […]

Avoiding Improper Medicare Payments for Surgical Dressings

Improper Payment Reasons Durable Medical Equipment (DME) suppliers of surgical dressings and physicians submit claims for surgical dressings and CMS covers it under the surgical dressings benefit i.e., SSA Section 1861[s][5]. CMS recently published the Medicare Fee-for-Service (FFS) improper Medicare payment rate for surgical dressings for the 2020 reporting period. For this reporting period, the […]

Basics of Medicare Remittance Advice (RA)

The A/B Medicare Administrative Contractors (A/B MACs), and Durable Medical Equipment Medicare Administrative Contractors (DME MACs) send to providers, physicians, and suppliers, as a companion to claim payments, a notice of payment, referred to as the Remittance Advice (RA). RAs explain the payment and any adjustment(s) made during claim adjudication. For each claim or line […]

Medicare R&N Requirements for Glucose Monitors

Home blood glucose monitors (BGMs) and continuous glucose monitors (CGMs) are covered under the Durable Medical Equipment (DME) benefit. In order for a beneficiary’s DME to be eligible for reimbursement, the reasonable and necessary (R&N) requirements set out in the related Local Coverage Determination (LCD) must be met. In addition, there are specific statutory payment […]

Medical Facility Should Follow The 6 Documentation Rules

6-documentation-rules-every-facility-should-follow

Documentation is a critical undertaking in any specialty medical facility. It is an essential tool for conveying essential clinical information about each patient’s diagnosis, treatment, and results and for communication between physicians, medical billers and coders, and the payers. Doctors and their team of medical billers must efficiently respond to the questions that payers are […]

DME Modifiers and Frequently used ICD 10 Codes

Durable Medical Equipment (DME) offer therapeutic benefits to patients who need its assistance owing to certain medical conditions. The items may either be rented or purchased, depending on a number of factors. These, though have set rules for opting either. The rental period for the item is generally 13 months after which the patient may […]

DME Modifiers- Know more to get more!

Durable Medical Equipment (DME) like Crutches, canes, special cots, wheelchairs, slings, electrodes, etc are being frequently prescribed by physicians to help out people who have suffered injuries. However, there are several models and types available with a host of features. It is important that an injured person gets the correct equipment at an affordable price. […]

How can DME billing services bag big orders from hospitals & increase their billing?

With health systems, medical centers, hospitals, and physician practices facing dismally low reimbursement figures and increasing risk and margin pressures breathing down their necks improving revenue are of paramount importance. Revenue cycle management experts are advocating improvements and the efficient management of accounts receivable as well as charge capture, coding, processing of claims, secondary billing, […]

Understanding pitfalls in DME billing

Billing is a vital aspect of any business, and healthcare is no exception. Millions of dollars can be lost if pitfalls are not understood and are repeated time and again in the billing and coding of medical practices, especially for ‘Durable Medical Equipment (DME).’ This equipment typically serves a medical purpose and is used routinely. […]

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