Month: March 2018

  • DME Billing
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    Increase Collection of Durable Medical Equipment (DME) Provider’s

    Medical billing and coding is an integral part of your revenue cycle management. It not only concentrates on posting accurate payments but invariable increase the collection of your facility as well. Today, most medical facilities, solo practitioners, healthcare units and clinics employ dedicated medical billing and coding companies to optimize the entire income cycle. This way, they can fully concentrate on their core undertaking, while the experts at charging do their job. In simple terms, Durable Medical Equipment refers to wheelchairs, braces, shower chairs and other assisted living equipment needed by the patients. These gears are generally purchased as an outpatient entity. Preapproval in DME billing is critical It does not matter if your patients are insured through Medicare, Medicaid, and Workers’ Compensation or through a private insurance carrier. Almost all DME claims must be pre-approved prior to submission of the medical billing claims. Many of these policies have strict guidelines, which must be followed in order for the DME medical billing claim to be reimbursed. Some providers will require that the DME be purchased through their own sources and have a listing of specified providers. Many HMOs are very strict about the DME they will reimburse a medical billing…

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  • DME Billing
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    A bid program for Durable Medical Equipment(DME)?

    Recently the Medicare Payment Advisory Committee (MedPAC) made payment policy recommendations for non-competitively bid Durable Medical Equipment. And if internal reports are to be believed, MedPAC plans to recommend that CMS shift more products away from the excessive fee schedule to bid rates. Also, it plans to call for immediate reduced payment rates for certain non-CBP products, while CMS works on incorporating them into the CBP. Alternatively, there are plans to recommend a policy option that would have CMS consider capping balance billing (specialty billing) at a percentage of the fee schedule rate and reduce the allowed amount by 5% for non-participating providers. Shifting the Bidding Program can DMEs a fortune A new research paper published in Health Affairs found that Medicare’s competitive bidding program is expected to save CMS $25.7 billion on durable medical equipment. This amount is calculated on a 10-year basis.  The program is expected to save about as much as what large commercial insurers save by negotiating with suppliers. The research found out that the early stages of the Medicare Durable Medical Equipment Billing; Competitive Bidding Program resulted on average of 35% lower prices than the CMS’ 2010 fee schedule, which is how CMS determined payment…

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