Month: January 2017

  • DME Billing
    5-issues-for-dme-practices-to-keep-top-of-mind-in-2017

    5 issues for DME practices to keep top of mind in 2017

    The year 2017 could prove a turning point for the healthcare industry. Slowing limping back into normalcy, most healthcare practices have found some stable ground. This, however, may be rocked again, with a change in political reforms that could even repeal the ACA or popularly called Obamacare act. It would not be difficult to surmise what the main issues for DME practices, especially in the DME practice, could help still maintain equilibrium, despite the coming turbulence. Keep in mind the below 5 issues and your DME practice could sail past the chopping waters: Physician signature: If a claim does not have a physician signature than it would be deemed insufficient. Documentation: Clarity and stringent checks on documentation, both clinically as well as administrative could definitely help strengthen your practice. For instance, if medical documentation displays a different code than the one that was billed, or if services were performed by someone other than the billing provider, then the payment is considered improper. Coding: Know what items can be billed and define the purpose clearly. Overbilling can attract audits which could be a cause for concern. So prepare a checklist of items and keep updated with the CMS and payers rules…

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  • DME Billing
    what-will-2017-bring-for-dme-practices

    What will 2017 bring for DME practices?

    A recent 2016 report by Grand View Research predicted that the durable medical equipment (DME) market is expected to reach USD 242.1 billion by 2024. This will probably turn out right, going by the simple logic that the aging population need for chronic disease management tools and devices and remote monitoring devices will increase in the coming years.  So the physicians and healthcare providers, who are still deciding whether or not to take up DME services as an ancillary service to their practice, will see a greater inflow of revenue keeping the Revenue Cycle Management (RCM) profitable, given the growing need of the geriatric population for use of durable medical equipment. Although Obama care may and could be rescinded in the coming months, yet certain basic concepts like reducing the length of hospital stay, a key strategy to help reduce medical expenses by the state, will lead to an increase in home healthcare settings. Reduction in length of stay at hospitals will inevitably increase focus towards home healthcare. Hence, for long term care and post-operative recovery, home healthcare will be the preference and will boost the demand in home healthcare. Already with the aid of government funding and public private partnership the…

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  • DME Billing
    how-to-reduce-denials-in-dme-billing

    How to reduce denials in DME billing?

    Rejection and denials in DME billing impact reimbursement and cash-flows disrupting the Revenue Cycle Management process. Added to the denials, increased regulatory scrutiny is pushing most DME services to revamp their operations to streamline processes and enhance profitability too. However, the need to question and analyze the reason why denials and rejections take place is essential for most DME billing services. Here is a checklist that can be employed to understand why denials are happening and reduce the denials making the claims process a smooth and profitable one. Verification and eligibility of Patient: Staff needs to check whether or not the patient is insured and covered for DME services and what kind of DME services they are eligible for. No claims should be processed without rechecking this information. Even backchecking of spellings of names, an information box checked wrongly, etc can lead to denial of the claim Coding and modifiers: If an invalid modifier or a required modifier is missing, the DME billing claim can be rejected. It is essential that a standard chart is updated every week so that if any changes brought in by any regulation can be immediately notified to the team of DME coders and billers.…

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