A good DME billing workflow ensures an effective Revenue Cycle Management (RCM) process. Moreover, with the minimum of errors in your DME billing, the process for claims management and thereby the Accounts Receivable (A/R) collections also improves impacting the RCM process providing for healthy cash inflows.
So what are the necessary ways to ensure that your DME billing process will help speed the A/R collections?
Here are some 5 simple yet effective ways to make effective DME billing efficiency and thereby speed up the A/R collections at your practice
Verification & eligibility of insurance coverage:
This is most necessary to ensure that when the DME services are billed, the patient’s insurance coverage has been verified and the services/ equipment/s are covered by the insurance or by Medicare. If not, this could lead to delays in payment and resubmissions which could prove costly in the long run
Trained in-house staff / Outsourced expertise:
No matter what you go for in-house DME billing or outsource, workers employed in handling the claims submission need to be knowledgeable about the different rules and requirements for claims submissions. The healthcare regulation changes can impact the RCM process and DME services can see reimbursement rates drop by 50 percent at any given time if one is not aware of the updated regulations
Coders need to be well versed with the coding, especially when it comes to DME services and the equipment used. The mere error in just a transposed number in a claim code, or even entering an outdated modifier, can lead to a rejected or denied claim, leading to a loss of timely reimbursement
Effective Claims Management process:
Follow-ups are very essential for an effective Billing workflow and A/R collection. It is known that many DME services lose an average of about seven percent of their reimbursements due to rejections and/or denials and no follow-ups of the claims. This ineffective claims management process is costly to the RCM of any medical practice. According to an American Medical Association study, it was found that medical offices waste about $14,600 each year on rectifying denied claims through appeals, phone calls, and troubleshooting.
Automation in electronic Health records (EHR), enhanced Practice Management systems, improved monitoring and enabled alert systems to go a long way in making the claims process a much more effective and efficient system to improve the A/R collections.
The above 5 tips need not all be simultaneously be made effective as it could be a costly overhead. But, with planning and possibly even outsourcing just the billing and/or the claims management process, your DME services can be made to be more efficient and thereby a much more effective A/R collections process can be implemented. The bottom line is to see that your reimbursements keep flowing in to provide for a healthy and profitable RCM process.