With new rules and regulations, product substitution has been of utmost importance. This is added with new reimbursements plans that quite often lead to a loss of revenue. It ends up affecting all – physicians, patients, DME providers, healthcare staff, etc. Every now and then, product substitution occurs because many physicians and/or patients are unaware […]
Long-standing concerns in DME (Durable Medical Equipment) known for unquestionable billing practices, led the government to take action for tackling fraud in the insurance industry. Medicare, the nation’s largest health insurance program, regulates the billing structure of the maximum number of healthcare providers. Due to its highly fragmented nature, Medicare is prone to widespread fraud […]
Getting credentialed with the right insurance panels is key to growing your practice revenue. However, Credentialing for Optometry Practices can be a daunting task. Are you aware that a Medicare application is a minimum of 30 pages for a solo provider and may surpass 50+ pages if you are a corporation or group practice? Even […]
According to bcbsnc.com, “Durable medical equipment (DME) is any equipment that provides therapeutic benefits to a member because of certain medical conditions and/or illnesses, and that can withstand repeated use, is primarily and customarily used to serve a medical purpose, and is appropriate for use in the home.” DME items include wheelchairs, cranes, orthotics, compression […]
Billing is the chief characteristic of any business. The same holds true for DMEs (Durable Medical Equipment); which denotes billing for the usage of medical equipment and supplies. DME includes wheelchairs, nebulizers, oxygen, traction equipment, walkers, kidney machines, crutches, ventilators, etc. DME is covered in certain illnesses under selected preconditions such as – if it […]
The far-reaching effects of ICD-10 will have to be understood by all in healthcare in order to deal with the impacts. The ICD-10 coding system that will kick in on October 01, 2015, is stated to be more comprehensive and much more advanced than its predecessor ICD-9. It is a known fact that Orthopedic and […]
Healthcare is an evolving industry and the tribulations faced in this volatile industry are immense. There are new diseases being discovered which have to be diagnosed and battled. With technological advancements, it is observed that physicians are spending less time with patients and more on the billing aspect. Hospitals are not paying as high as […]
Physicians who are part of DME services now face an important operational decision: whether to persist with in-house billing staff or entrust to external sources. The long-held belief that in-house billing staff would manage DME-related billing complexities seems to have failed them recently – most of the in-house-staff-managed DME billing are reported to have high […]
There is a distinctive difference between billing for Durable Medical Equipment (DME) services and other clinical procedures – durable medical equipment services are ancillary to the primary clinical purpose, and their admissibility is subject to certain conditions. One of the best ways to overcome the DME billing challenges is outsourcing the DME billing services and […]
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