Year 2020 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 the 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 & regulations
- Dispensing of DME equipment: If you look at DME services as an ancillary income to your current practice, then be sure to apply for a Durable Medical Equipment Regional Carrier (DMERC) license to dispense covered items for Medicare patients to dispense Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS).
- Verification & eligibility of patients: Automate & streamline this process of verification and eligibility of your patients. It will have a two-fold benefit- happy patients and lowered DME claim denials making your billing a breeze
Keeping this in mind, no matter what changes may come through in pandemic due to political or legislative reforms that can affect CMS funding, having the above aspects of your practice streamlined and vigilant checks in place, your ship will sail through any chopping waters getting you to safe harbors intact.