It is a well-known fact that DME billing can be nerve-racking, given the changing regulations and rules not just by federal agencies but also by payers. Moreover, the DME categorization and its usage are given “medical necessity” and the pre-authorization and authorization requirements can be tedious and time-consuming to incorporate when dealing with documentation.
Hence, when you outsource the DME services there are 5 benefits you can be assured of:
The trained staff takes care of all the billing details of the patient, not just their personal demographics but also the name of the medical provider, the medical service rendered, and the date of the patient’s visit. Ensuring that every detail is accurate and verified.
The charge entry process:
The most crucial component in the billing cycle which ensures your healthy revenue and where the claims process is most critical for your RCM process. This process ensures that insurance claims are processed accurately with all information like the fact sheet of the patient, physician details, details of insurance coverage of the patient, and billing information.
Part of the above charge entry process. Stringent documentation ensures appropriate charges are assigned to the codes provided by the team of DME coders who are experts and well versed with the medical coding systems such as, HCPCS, CPT, ICD-10 codes
This can be very time consuming right from follow up with patient’s appointments to doctor’s prescription, insurance verification, confirmation of rental DME, A/R & timely installment posting to reflect accurate A/R collections. All this leads to decreased time in and/or front end rejections
Reduction in administrative and operation costs:
Costs of telephone expenses, payroll, office space, postage, health insurance, workers compensation insurance, absenteeism, taxes and training, hardware, and software – infrastructure is all taken care of by the outsourced vendor. Vendors also take care of customized reporting as per the federal and state requirements
When you outsource, the biggest benefit impacts your in-house staff. They now have the bandwidth to focus on clinical needs, and get ready & experts information for DME charging and coding. Given the outsourced vendor’s specialization in DME billing, they are able to resolve insufficiencies encountered in billing, are updated with all payers payment which may be acceptable to one payer may not be acceptable to another, and deal with discrepancies much quickly reducing the appeals time-consuming process which consequently helps process claims faster and efficiently providing for an effective RCM system.