Durable medical equipment billing and reimbursement

  • 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
    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
    Is-your-Facility-providing-accurate-billing-transaction-for-DME-orders

    Is your Facility providing accurate billing transaction for DME orders?

    DME – Durable Medical Equipment is normally used for people with certain medical requirements and which could be for repeated use too. Moreover, DME can also be used at different times and could be just rented out for specific periods or for long-term usage, or on a permanent basis. The complexities are many when it comes to billing for DME services, given the CPT codes and modifiers to be used and when. Added to this, some payers may or may not reimburse depending on their coverage or rules & regulations as each payer may have a different reimbursement component attached. Overbilling is one of the major issues that most medical providers of healthcare face when it comes to the DME billing process. This has led to the initiation of a number of audits by the OIG and can be a cumbersome affair. Checklist to determine accurate DME billing In order to determine if your facility has made provision for accurate billing transactions for DME orders, here is a checklist to work with. Modifier usage: Using appropriate modifiers and coding to the highest level of specificity requiring modifier use is very pertinent to accurate billing for proper reimbursements. Certified DME coders…

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