Revenue Cycle Management (RCM)

  • 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
    Out of Pocket Payments and your DME facility!! What you should know?

    Out-of-Pocket Payments and your DME facility!! What you should know?

    There are certain considerations when you are choosing health insurance is a plan’s out-of-pocket costs. These are the healthcare expenses that you pay yourself, i.e. out of your own pocket. Out-of-pocket expenses are paid in addition to your monthly premium for health insurance. In order to minimize your healthcare costs, you need to look at your total annual spending for healthcare which includes not just your monthly premiums but also all the money you pay towards deductibles, copayments, coinsurance, and other out-of-pocket expenses. As more and more Americans age in place, or remain living at home instead of moving into skilled nursing homes or assisted living residences, there has been an increased need for seniors to purchase durable medical equipment – DME.  Every year, approximately $50 Billion is spent on durable medical equipment in America, wherein 25% percent of which is paid for directly out-of-the-pocket of consumers. It is important to find other financial assistance programs and minimize their out-of-pocket spending on DME. Before we go with the discussion, it is important to know what we consider as DME Durable Medical Equipment (DME) as well as the terms, Home Medical Equipment (HME) and home healthcare equipment are used interchangeably. They…

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  • DME Billing Services
    Best Practices to Optimize your AR days for DME facilities

    Best Practices to Optimize your AR days for DME facilities

    A professional DME facilities and billing workflow ensure to have increased 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, the patient’s insurance coverage has been confirmed and the services/equipment 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…

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  • DME Billing Services
    Benefits of Hiring a Durable Medical Equipment Billing and Coding Agency

    Benefits of Hiring a Durable Medical Equipment Billing and Coding Agency

    As per industry research, 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 that 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 considered as DMEs is prosthetic devices, wheelchairs, oxygen equipment, insulin pumps, walkers, hospital beds, power mobility devices, etc.  It is known that around 80% of the bills contain errors of some sort of the other, either incorrect details or the inability to follow the latest rules and regulations. It also…

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  • DME Billing Services
    DME-suppliers-favoring-Offshore-Billing-Agencies

    Why are DME suppliers favoring Billing companies?

    Going outsource from your local demographics to attain a higher return on investment is the latest trend engulfing healthcare units, clinics, hospitals, and outpatient facilities in the U.S. Partnering medical billing companies help Physicians to effectively survive and make an impact in tough economic clout, as they are specialists in resolving delayed payment issues, lagging A/R days, denial and follow-up management and most importantly cut down the errors in medical billing and coding of your DME supplies. What did you get with a DME Medical Billing Agency? DME medical billing agencies provide practitioners and insurers quick access to talented resources, which are prepared to execute assigned tasks immediately. Value-added services with satisfactory results are the need of the hour for many DME suppliers. Hiring a company that only deals in delivering revenue-based result not just emphasizes the cash flow, but brings to fore a streamline and combined effort to desired results. These billing companies provide end-to-end and a comprehensive medical billing service. They also take up short term projects helping in clearing the A/R back-logs, as DME billing agencies are flexible and quickly adopts changes to provide good process results. Keep in mind that a good company combines both its…

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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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