DME billing service

  • DME Billing
    Specialization consideration for DME suppliers in medical billing and coding

    Specialization consideration for DME suppliers in medical billing and coding

    Durable medical equipment billing is the process by which insurance companies are charged for the services provided to their clients. And in order to achieve the complete reimbursement dollars billing codes that represent different aspects of the DME process are implemented. The characters the biller enters relate to different aspects of a diagnosis or procedure and allow the information to be uploaded for billing without having to manually define either diagnosis or procedure. This allows the process to be implemented faster without having to describe everything in detail. When we talk about specialization consideration in DME suppliers’ one specialty that often crosses the supplier’s path is Orthopedics. Orthopedic facilities often provide patients with supplies, such as casts and canes, which is integral to patients’ treatment plans. What DME supplies can be used for an orthopedic treatment and how to charge for them? The Current Terminology Codes (CPT) published in the American Medical Association’s are used for professional DME coding. These codes are frequently known as Level I of the Healthcare Common Procedure Coding System (HCPCS). DME suppliers are categorized as Level II HCPCS codes and are recognizable by their alpha-numeric structure. Just like CPT codes, Level II HCPCS codes are…

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  • DME Billing
    Critical factors to consider before you outsource DME billing and coding

    Critical factors to consider before you outsource DME billing and coding

    Durable Medical Equipment (DME) as a healthcare industry field is different from other specialties and so is its medical billing and coding requirements. You need an in-depth and specialized knowledge of all the updated HCPCS Level II codes as DME claims are classified under HCPCS Level II. And as to speak about DME suppliers, the complex nature of reimbursement is another challenge they constantly face. Since patients can rent the expensive equipment rather than purchase, DME billers and coders must be conscious of exactly how to code claims and when to send them for getting the precise reimbursement amounts. What this means is that the code should lay down the equipment was rented and not purchased. The rental period should be recorded separately on the claim so that the insurance company will pay a small reimbursement for each of those days. Outsourcing your DME medical billing tasks facilitates a smart solution for your hospital billing requirements, assisting you to organize the entire billing and collection process at a portion of your current operating costs. If you want to make the in-house workload a bit lighter, it’s a great idea to consider outsourcing your DME billing. Here are some important ways…

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  • DME Billing
    Advantages of outsourcing DME billing

    Advantages of outsourcing DME billing

    Administrations of Durable Medical Equipment (DME) can be a tedious and time-consuming task. In addition to other things, it requires inside and out knowledge of reimbursement rules of Medicare, Medicaid and Commercial Plans, and their admonition. It likewise requires consistent adherence to quality and staying side by side of the considerable number of change events in repayment regulations and coding and documentation prerequisites. When you outsource your medical billing operations, the billing team focuses exclusively on the filing of claims, so there is no pressure on them to treat urgent patients or save lives. They take the workload off your back, freeing up your doctors and team to focus on other matters. There are several advantages of outsourcing DME billing, some of the advantages are listed below: More Control: It is a common misconception that by outsourcing your medical billing services you can lose control over your business processes. In fact, many people feel that they have better control over their medical billing processes and the money involved due to a trained and dedicated outsourced billing staff. This increased control directly ties in with your operational benefits, which stand to benefit from outsourcing. Increased Revenues: Employing staff for billing purposes…

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  • DME Billing
    Updated DMEPOS Codes Fee Schedule 2019

    Updated DMEPOS Codes Fee Schedule 2019

    The Centers for Medicare & Medicaid Services (CMS) updates the DMEPOS fee schedule on an annual basis in accordance with statutes and regulations. Payment on a fee schedule basis is required for certain Durable Medical Equipment (DME), prosthetic devices, orthotics, prosthetics, and surgical dressings by Section1834 (a), (h), and (i) of the Social Security Act (the Act). Additionally, payment on a fee schedule basis is a regulatory requirement at 42 Code of Federal Regulation (CFR) Section 414.102 for Parenteral and Enteral Nutrition (PEN), splints, casts and Intraocular Lenses (IOLs) inserted in a physician’s office. The DMEPOS and PEN fee schedule files contain Healthcare Common Procedure Coding System (HCPCS) codes that are subject to the adjusted fee schedule amounts under Section 1834(a)(1)(F) as well as codes that are not subject to the fee schedule Competitive Bidding Program (CBP) adjustments. New Codes Added New DMEPOS codes added to the HCPCS file, effective January 1, 2019, where applicable, are A4563, A5514, A6460, A6461, B4105, E0447, E0467, L8608, L8698, L8701, L8702, V5171, V5172, V5181, V5211, V5212, V5213, V5214, V5215, and V5221. The new codes are not to be used for billing purposes until they are effective on January 1, 2019. As part of this…

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  • DME Billing
    Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule Update 2019

    Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule Update 2019

    CMS happen to announce in the year 2019 about Medicare fee schedule rates for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). The 2019 update factor is 2.3%, although other pricing policies are applied in specific circumstances. The DMEPOS and PEN fee schedule files contain the Healthcare Common Procedure Coding System (HCPCS) codes that are subject to the adjusted fee schedule amounts under Section 1834(a)(1)(F) as well as codes that are not subject to the fee schedule Competitive Bidding Program adjustments. For CY 2019, the following Fee Schedule Adjustment Methodologies apply and fee schedule amounts are based on the area in which the items and services are furnished. Fee Schedule Amounts for Areas within the Contiguous United States To determine the adjusted fee schedule amounts, the average of Single Payment Amounts from CBPs located in eight different regions of the contiguous United States are used to adjust the fee schedule amounts for the states located in each of the eight regions. These Regional SPAs or RSPAs are also subject to a national ceiling 110 percent of the average of the RSPAs for all contiguous states plus the District of Columbia) and a national floor (90% of the average of the…

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  • DME Billing
    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
    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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