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 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 gets difficult for a hospital administration to reduce errors, verify demographics and insurance on a regular basis, follow up on claims and payments, hence the need to outsource billing and coding services becomes essential
Policies for DME Codes Remember that any time you use an HCPCS Level II code that ends in 99, such as, E1399 Durable medical equipment, miscellaneous, provide supporting documentation to bill that code. Once Medicare receives a miscellaneous code, the claim is suspended and medical records are requested. The records are then checked for several possible issues. Next, the miscellaneous code is reviewed to see if another code is more appropriate to a bill.
Also, keep in mind that most medical gears have a code appointed. If the piece of equipment does not have a code assigned, then the manufacturer’s invoice is reviewed for an allowable. In the final stage, the medical necessity is verified before payment is made. If the in-house billers are facing a dilemma regarding code for a particular item you can check with Statistical Analysis Durable Medical Equipment Regional Carrier (SADMERC). Their guidance to manufacturers and suppliers on proper usage of HCPCS codes in regards to DMEPOS services identified for Medicare billing.
Not just churning out clean claims DME medical billing companies also provide daily reporting and real-time access to all the claims processed. These reports assist the medicinal services experts with understanding their practice/business better. It distinguishes diverse reimbursement rates for every strategy by various insurance agencies. Month-end reports additionally help to comprehend comprehensive, bundled procedures by demographics. It additionally provides a demographic classification of a patient by insurer. A/R report clearly indicates the outstanding balances by A/R days, insurance and patients.
Medical Billers and Coders have more than 100 Durable Medical Equipment (DME) Clients and for all of them, we have provided a customized solution relating to the practice revenue, number of patient visiting facilities, type of equipment and demography. With our revenue managers, we channelize the billing to reduce billing errors and maximize revenue growth.