DME billing

  • DME Billing Services
    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 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 by…

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  • DME Billing Services
    Advantages of outsourcing Durable Medical Equipment billing

    Advantages of outsourcing Durable Medical Equipment billing

    Administrations of Durable Medical Equipment (DME) billing 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 Durable Medical Equipment Billing, some of the advantages are listed below: 1. 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. 2. Increased Revenues:…

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  • DME Billing Services
    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 Services
    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 happens 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 Services
    Advantages of Online Durable Medical Equipment Shop

    Advantages of Online Durable Medical Equipment’s (DME) Shops

    It’s estimated that even more people will opt into online durable medical equipment’s and supply for the delivery.  Since 2007, the industry has nearly doubled in size, with more people choosing it as their primary method for getting supplies; it has been witnessing a constant rise in DME billing too. The increase in in-home care has also led to more need for convenient supply access.  For many, the advantages of brick-and-mortar retailers are just too great to ignore. The industry is also set to go on growing at a six percent rate for the next couple of years. Are there any advantages to buying my medical supplies online? Well, it’s been proven that online medical supplies are not only cheaper but also in most cases more available as opposed to going around searching for a physical store that has all the products you need. DME Billing That Covers Medicare It is best to think of Medicare’s durable medical equipment coverage as having 2 levels: DME billing is covered when determined to be medically necessary and DME that is never covered despite being medically necessary. For example, grab bar rails may be completely necessary for an individual, but Medicare does not consider…

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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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