Month: March 2017

  • DME Billing
    3-most-commonly-used-software-for-dme-billing

    3 most commonly used software for DME billing

    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…

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  • DME Billing
    some-questions-you-need-to-ask-your-dme-billing-service-provider

    Some questions you need to ask your DME Billing Service provider

    As a physician, you feel responsible both towards your patient and staff to verify that all is going well. So too, when you make the decision to outsource your DME billing services – you need to constantly track and check all aspects of the services provided by the DME provider. The reason being- you need to meet compliance and also make strategic decisions from time to time, given the changing healthcare rules & regulations. Wondering what are the questions you need to ask your DME billing service provider? As a physician, you need to remember that the most important component of your practice is to keep the revenues flowing. For this, to work you need to ensure that not just the coding and billing is being done by certified billers & coders but also are they meeting the compliance when processing for claims. The most crucial question however you should be asking your DME service providers is, “Are the DME claims in accordance with Healthcare Common Procedural Coding System (HCPCS) Level II coding guidelines and national and local coverage determinations (NCDs and LCDs)?” Further, when a claim is received, Medicare determines if the ordering/referring provider is required for the billed…

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