How to Maximize Revenue with Improved Claims Denials

  • DME Billing Services
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    How to reduce denials in DME billing?

    Rejection and denials in DME billing impact reimbursement and cash-flows disrupting the Revenue Cycle Management process. Added to the denials, increased regulatory scrutiny is pushing most DME services to revamp their operations to streamline processes and enhance profitability too. However, the need to question and analyze the reason why denials and rejections take place is essential for most DME billing services. Here is a checklist that can be employed to understand why denials are happening and reduce the denials making the claims process a smooth and profitable one. Verification and eligibility of Patient: Staff needs to check whether or not the patient is insured and covered for DME services and what kind of DME services they are eligible for. No claims should be processed without rechecking this information. Even backchecking of spellings of names, an information box checked wrongly, etc can lead to denial of the claim Coding and modifiers: If an invalid modifier or a required modifier is missing, the DME billing claim can be rejected. It is essential that a standard chart is updated every week so that if any changes brought in by any regulation can be immediately notified to the team of DME coders and billers.…

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