medical billers and coders

  • 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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  • DME Billing
    some-questions-you-need-to-ask-your-dme-billing-service-provider

    Some questions you need to ask your DME Billing Service provider

    As a physician, you feel responsible both towards your patient and staff to verify that all is going well. So too, when you make the decision to outsource your DME billing services – you need to constantly track and check all aspects of the services provided by the DME provider. The reason being- you need to meet compliance and also make strategic decisions from time to time, given the changing healthcare rules & regulations. Wondering what are the questions you need to ask your DME billing service provider? As a physician, you need to remember that the most important component of your practice is to keep the revenues flowing. For this, to work you need to ensure that not just the coding and billing is being done by certified billers & coders but also are they meeting the compliance when processing for claims. The most crucial question however you should be asking your DME service providers is, “Are the DME claims in accordance with Healthcare Common Procedural Coding System (HCPCS) Level II coding guidelines and national and local coverage determinations (NCDs and LCDs)?” Further, when a claim is received, Medicare determines if the ordering/referring provider is required for the billed…

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  • DME Billing
    5- ways-to-ensure-accurate-billing-for-durable-medical-equipment-orders

    5 ways to ensure accurate billing for durable medical equipment orders

    DME billing and coding is a very complex system and involves a certain level of expertise. Besides expertise, awareness and knowledge about the constantly changing coding system by CMS help ensure accurate billing that helps reap rewards. Here are a few ways that can help ensure accurate billing for DME services: Awareness of kinds and types of modifiers: Modifiers are known to influence fee schedules and help fix prices paid for DME. Moreover, the reimbursements for rental and purchase are not always the same. Each modifier should be studied in detailed, understood what they mean and when each can be used appropriately. Coding when using components and accessories: especially wheelchairs carry specific codes for components and accessories of wheelchairs which need to be employed appropriately Terminology: It is imperative to know how and when specific terms can be employed to ensure accurate billing. For example, a power wheelchair with attachments like a basket or headlights may not be classified as “custom” and can only be termed a wheelchair with extra options. Here, HCPCS is appropriate for the base and the extra components can be billed under a separate heading. Operational Protocols: To ensure accurate billing, the need to establish operational…

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