billing services for doctors

  • DME Billing Services
    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 Services
    durable-medical-billing-facilities-need-outsourcing-medical-coding

    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 Services
    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 Services
    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 Services

    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 Services
    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 that 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 a more transparent payment model we are here to weigh 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 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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  • 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 owned 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’ contracts 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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