A professional DME facilities and billing workflow ensures to have increase revenue. With errors and mistakes in your DME billing, the process for claims management is hindered and thereby the Accounts Receivable (AR) collections have a deep impact overall reducing the healthy cash inflows.
So what are the best practices to optimize your AR days for DME facilities? Here are some 5 simple yet effective ways to make effective your billing efficiency and thereby speed up the A/R collections at your practice
- Authentication & eligibility of insurance coverage
This is most necessary to make sure that when the DME services are billed, patient’s insurance coverage has been confirmed and the services/ equipment’s are covered by the insurance or by the Medicare. If not, this could lead to delays in payment and resubmissions which could prove costly in the long run
- Trained in-house staff or Get 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 60% percent at any given time if one is not aware of the updated regulations.
- Stringent Coding
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 The mere error in just a transposed number in a claim code, or even entering an outdated modifier, can lead to a rejected or denied claim, leading to a loss of timely reimbursement.
- Operative 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 $17,500 every year on rectifying denied claims through appeals, phone calls, and troubleshooting.
- Improved Technology
Automation in electronic Health records (EHR), enhanced Practice Management systems, improved monitoring and enabled alert systems go a long way in making the claims process a much more effective and efficient system to improve the A/R billing.
The above 5 practices need not all is simultaneously be made effective as it could be costly expenditure. But, with careful planning and possibly even outsourcing just the billing and/or the claims management process, your DME facilities can be made to be more efficient and thereby a much more effective A/R collections can be implemented. The bottom line is to see that your reimbursements keep flowing in to provide for a healthy and profitable process.
The process for DME facilities and billing can be cumbersome due to its inherent nature, starting with the order generated from a physician’s office. DME, Prosthetics & Orthotics companies expend valuable time coordinating and communicating with the ordering physician’s office for a valid Rx, medical/therapy notes, etc.
Equipment requiring prior authorization also can involve innumerable follow-up calls. A methodical and streamlined process effectively manages this process, tracking each request in detail, thus ensuring timely follow-up. Payer guidelines are specific to diagnosis. A thorough knowledge of this results in drastically reducing denials.