Health Insurance

  • DME Billing Services
    lacking-in-ar-management-can-harm-your-durable-medical-equipment-revenue

    Lacking in AR Management can Harm Your Durable Medical Equipment Revenue

    Accounts Receivable (AR) is a key parameter in the financial division of every healthcare facility. It is defined as the money owed by the healthcare facility for the services rendered to the patients. Being a vital aspect of the revenue cycle management, the cash flow of the healthcare facility is directly proportional to the managing of AR. AR is calculated as: Total charges for last 6 months/number of days in last 6 months = average daily charges Total AR / average daily charges = days in AR AR can be duly managed if the medical billing and coding professionals are knowledgeable about coding parameters, insurance rules, timely claim filing and follow up (of regular and rejected claims). Usually, the healthcare facility is paid by the insurance and the patient. A delay in either of these negatively affects revenues and leaves a great deal on the table. Hence, it is imperative to monitor the AR on a continuous basis. And this must be done by professionals who know the healthcare practices’ contract terms claims adjudication. The professionals managing AR must also know how to calculate copays which the patients are required to pay. Other practices to be followed are: prior authorization,…

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  • DME Billing Services
    Are You Conducting The Right Follow Up On All The DME Denied Claims?

    Are You Conducting The Right Follow Up On All The DME Denied Claims?

    Getting to know the basics of denial management is vital for successfully running a medical practice and Durable medical equipment (DME) facility. Facilities that are showing positive bottom-line numbers at the end of each month will generally have denial rates below 2%-3%. Also, nowadays payers are embarking system software’s so they can identify different payment procedures that apply the contract requirements. For some insurers, it seems that the procedure is skewed to effect denial, whenever anything is unclear. Along with this, most insurance companies expect only a fraction of DME facilities to follow-up on the claim and resubmit a corrected version. Clearly, producing clean claims saves facilities money. Indeed, even with the rising number of claims being denied all the time, DME facilities must not lose heart. There are numerous ways to answer the issue of, how to rectify increasing claim denial rates. Practices can obviously target regular zones of through where a claim denial occurs, but looking beyond the traditional norms is not just enough. Today, even a minute DME billing and a coding mistake can lead to a denial or delayed reimbursement. And in such a scenario, if you are not applying the right kind follow up procedures,…

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  • DME Billing Services
    Reasons-why-your-DME-facility-might-not-be-generating-revenue

    5 Reasons why your DME facility might not be generating revenue?

    DME facility is majorly dependent on the mandates and regulations set by the federal government.  The recent news of DME facilities overlooking the patient safety and the reselling of Home Medical Equipment (HME) has pushed the states to look for the law to curb irregular treatment of patients. This has further complicated the compliance issues driving down the revenue.  Here is the look at some of the negating factors affecting your DME facility Reduced Inflow of patients For any DME facility, one factor that contributes greatly towards the reimbursement generation is a constant flow of patients. Durable Medical Equipment is usually stabilized equipment’s that after the rigors use of it becomes non-essential for the patient or if the patient needs to make continuous use of it will just need maintenance and repairs. The need for collateral tie-ups with physicians recommending their patients for your DME facility can act as a great booster. Furthermore, a DME facility can instill a marketing technique to promote their attractive rates and range of equipment. No future plan- Equipment and Reimbursement Flow DME facility needs to be prepared for the worst in such cases of bankruptcy or action against the facility. The need for the…

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