Medical Billers and Coders

Catering to more than 40 specialties, medicalbillersandcoders is proficient in handling services that range from revenue cycle management to ICD-10 testing solutions. The main goal of our organization is to assist physicians looking for billers and coders, at the same time help billing specialists looking for jobs, reach the right place.
  • DME Billing
    advantages-of-online-durable-medical-equipments-shops

    Advantages of Online Durable Medical Equipment’s Shops

    It’s estimated that even more people will opt into online durable medical equipment’s and supply for the delivery.  Since 2007, the industry has nearly doubled in size, with more people choosing it as their primary method for getting supplies; it has been witnessing a constant rise in DME billing too. The increase in in-home care has also led to more need for convenient supply access.  For many, the advantages of brick-and-mortar retailers are just too great to ignore. The industry is also set to go on growing at a six percent rate for the next couple of years. Are there any advantages to buying my medical supplies online? Well, it’s been proven that online medical supplies are not only cheaper but also in most cases more available as opposed to going around searching for a physical store that has all the products you need. DME Billing That Covers Medicare It is best to think of Medicare’s durable medical equipment coverage as having 2 levels: DME billing is covered when determined to be medically necessary and DME that is never covered despite being medically necessary. For example, grab bar rails may be completely necessary for an individual, but Medicare does not consider…

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  • DME Billing
    Which DME medical supplies are covered by Medicare Part B?

    Which DME medical supplies are covered by Medicare Part B?

    Durable Medical Equipment Billing is somewhat unique if we compare it with other specialty billing. Basically, Durable Medical Equipment (DME) gives therapeutic benefits to patients experiencing certain healing conditions and/or some diseases. So a DME is built to serve the medical purpose of patients for regular use at home or in a hospital or any other healthcare unit. Standard DME products (Part A and B) include: Wheelchairs Orthotics Slings Supports Cranes Pressure sleeves Nonetheless, it is astonishing that apart from the significance, DME billing has lots of uncertainty around it. It is extremely appalling that despite DME suppliers getting an adequate doctor prescription for provisions, they frequently struggle to cover their said revenue/income. Distinctive DME organizations have diverse DME billing styles relying upon the frequency. A few organizations charge consistently as and when required while a few others charge a couple of times as the year progressed. DME billing should be to a great extent be careful and precise as a single billing and coding error can lead to a major loss thousands of dollars for the DME merchant. The doctor may suggest a DME provider or the patient should look for one in his region. But, in any case,…

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  • DME Billing
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    Durable Medical Billing (DME) facilities need outsourcing medical coding?

    With over 19 years of experience in Durable Medical Billing (DME) through errors and compliances, we have understated a few paths for DME clients. Every month we add new clients with thousands of dollars are lost in mishandling and unpaid claims in numerous fields of healthcare, including Durable Medical Equipment (DME). Added to this is the multifaceted billing and coding procedures, and the claim requirements of Medicare, Medicaid, and other private insurance companies. To ensure accurate reimbursements and timely revenues, it is imperative to hire an outsourcing agency as it works as a smart solution and completes all the billing and coding requirements; and assists in organizing the entire processes at a fraction of the in-house operating costs. It also makes the in-house billing and coding department’s work a lot easier, less time consuming, and lesser issues related to legalities. Equipment which provides therapeutic benefits to patients who are in need due to certain medical ailments is categorized as DME. It is also known as Home Medical Equipment (HME) and is able to withstand repeated use. Equipment’s considered as DMEs are prosthetic devices, wheelchairs, oxygen equipment, insulin pumps, walkers, hospital beds, power mobility devices, etc. It is known that around…

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  • DME Billing
    Analyzing-Home-Medical-Equipment-HME-Future-Beyond-2018

    Analyzing Home Medical Equipment (HME) Future Beyond 2018

    Durable Medical Equipment (DME) suppliers have seen an upward trend in the regulation market. The brief history of Home Medical Equipment (HME) federal rules will provide us with an insight to understand the future of equipment’s for the market. In 2016, with the passage of the 21st Century Cures Act, the suppliers will now receive the adjustments for claims. After which many would consider they had a lengthy delay, the suppliers are beginning to get repayments. The problem with the implementation of Durable Medical Equipment (DME) MACs is that CMS had provided the 24 weeks for completion which concluded in November 2017.  The lengthy delay which happened to complete the implementation process for the quarterly update and the announcement of it by the CMS.  As of data received by CMS, the data reveals that 40.1 percent decrease in the location of DME suppliers nationwide since 2013. The figure gives an indication of How the DME market is currently dealing with instability due to competitive bidding especially in the nationwide expansion of bidding derived rates. The suppliers demand a need for reform to stabilize the market and thus what we might see in the future in term of the equipment market.…

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  • DME Billing
    Recent-Policy-Development-for-Durable-Medical-Equipment-Billing

    Recent Policy development for Durable Medical Equipment (DME) Billing

    The US Healthcare industry in its true sense is passing through a transition period, where each medical specialty is waiting on the fence, to find out if there is any further development to their current regime. In those specialties, the Durable Medical Equipment suppliers are also looking for information and updates that would normalize their business, streamline the revenue cycle and are hands-on with their DME billing and coding procedures. The use of durable medical equipment in the home, while not a recent development, was formally recognized by the Congress with the passage of the original Medicare legislation. Since that time the statute has been amended to provide for a more workable, economical, and desirable interface among the administrative, supplier, and user communities. So with regards to renting, purchasing or repairing and maintenance of Durable Medical equipment here are some developments you should keep in mind for perfect reimbursement. Durable medical equipment billing recent policy developments: As a thumb rule, DME requires a prescription to rent or purchase, as applicable, before it is eligible for coverage. Certain items must be rented and may not be purchased (under “Capped Rentals”). Certain other items must be rented prior to being converted to…

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  • DME Billing
    cms-relaxes-the-date-for-cures-act-changes-for-durable-medical-equipment-dme-billing

    CMS Relaxes the Date for CURES Act Changes for Durable Medical Equipment (DME) Billing

    CMS has now backed off from the initial date of Dec 31, 2017, and stated that it will work with state Medicaid programs for a different compliance and reimbursement plans. CURES ACT related to Medicaid update was first released in early December. In a view of various physicians and surgeons, CMS has now revised the ruling stating that Medicaid directors will not have an impossible deadline and will look to seek a more collaborative approach related to the compliance. The original letter dated Dec 27, 2017, stated that state Medicaid programs had to notify CMS of their decision of aggregate payment comparisons or alternative approach to compliance. This gave state programs a few days to make an important decision on medical billing. The new guidance issued by CMS on 4th Jan gave in the more flexible structure of guidelines for the state programs to follow. State facilities that decided to change their state Medicaid plan for the DME payment. For this the facilities who pay at or less than Medicare rates for the DME products or the facilities who have amended the state developed fee schedules, all the above facilities must submit a state amendment plan by March 31, 2018.…

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  • DME Billing
    Outsource-DME-billing-Do-you-really-need-it-This-will-help-you-decide.jpg

    Outsource Durable Medical Equipment (DME) Billing: Do you Really Need It? These will Help You Decide!

    Durable Medical Equipment Billing is a $1 billion industry which includes only the income for the providers. Insurance companies/ Medicare (payers) along with outsourcing medical billing companies act as the needed resources for the DME providers. As we see DME providers reaching out to the payers and regulators for more transparent payment model we are here to weight your options. Before we dive into understanding the requirements from you for DME medical billing We need to understand the guidelines laid for a Durable Medical Equipment (DME) Billing. A prescription is required to rent or purchase, as applicable, before it is eligible for coverage. Certain items must be rented and may not be purchased. Certain other items must be rented prior to being converted to purchase in accordance with BCBSNC medical policy.  All the bills for the DME should be typed on CMS-1500 (version 08/05) claim form. The entire applicable modifier should be applied after all HCPCS codes. All the bills for maintenance and repair should be first applied before the procedure code.  All the equipment’s for which maintenance and repair work is done a claim needs to be submitted. Use E1399 or other miscellaneous HCPCS codes only if no suitable…

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