Outsourcing DME (Durable Medical Equipment) Billing
In a constantly growing healthcare industry, Durable Medical Equipment (DME) have become an increasingly popular choice of healthcare-related services to millions of patients nationwide.
In fact, a recent survey performed on the DME products industry found that the market would grow significantly over the next 10 years. With the rising number of an aging population and an increase in the number of cases such as respiratory illnesses, home healthcare will continue to be in high demand.
However, with this increased usage, DME billing is turning out to be more and more complicated for healthcare providers.
Today, DME billing can be challenging and confusing, especially if your team is not up to date with the latest policies and procedures of the payor. It demands an in-depth knowledge of reimbursement standards of both Medicare and Medicaid, as well as commercial, private insurance plans. DME billing also requires a non-stop commitment to quality and keeping up to date with all the changes which occur within reimbursement guidelines and coding and documentation musts.
For an effective DME billing process and appropriate reimbursement, healthcare providers have a lot to watch out for, which can become a costly matter, both in time and money.
Before going any further, let’s look at a few definitions to make sure we’re all on the same page.
HME denotes medical equipment that is appropriate for a home environment and can be overseen by a patient or non-professional caregiver. HME billing extends over the total revenue cycle and originates with referrals from hospitals, clinics and physicians.
DME refers to any robust medical equipment that delivers therapeutic benefits to a patient with particular medical conditions. Examples consist of oxygen tanks, kidney machines, walkers and blood sugar monitors. A major chunk of DME is usually aimed at extending therapeutics relief for patients with a long-term critical condition. As such, DME is a category of HME.
Here are some typical challenges encountered in DME billing:
- Inexperienced billers and coders – Obviously, hiring a team of qualified billers and coders is paramount. As both government and insurance companies initiate new guidelines, it demands constant training and keeping track of the latest billing directives. Inexperienced billers, uninformed of the billing process or its rules, can mean a denial of claims and a loss of revenue.
- Inadequate claims management – Oft times, in-house billers wind up neglecting claims submissions and follow-up as they juggle between their administrative responsibilities and billing duties.
- Missing facts and figures – Missing and inadequate information translates to difficulties for the provider organization, leading to delays in the billing process, and would-be denial of claims.
- Coding errors – Perhaps the principal challenge in the DME billing process is coding errors. With the over-abundance of codes, inexperienced coders often input inaccurate codes, causing holdups in the billing process. Medical coding is a specialized segment and coders who work exclusively with coding and billing will know all the directory of codes that are used under DME services.
Truth is, a lot of DME providers are facing serious challenges in managing their front office work which leads to delayed payments, even a denial of claims. Finding a reliable partner that can help to eliminate any proven “pain” areas in your practice should be the way forward.
We have the unique ability of delivering it all with our DME billing services. Let’s see why.
The why’s and wherefore’s that make us a reliable DME billing partner:
- We have certified coders and billers to provide “best in class” service. Plus, our team reviews every claim before it’s sent to the payor. We make sure each one follows compliance and remains accurate throughout the process.
- Our billers and coders have the know-how to evaluate and deal with reasons for rejections and, where doable, re-submit claims and ensure their reimbursement by Medicaid and Medicare.
- Our billing specialists are comprised of experts on the most up-to-the-minute DME policies. This know-how will help you surmount any billing challenges your firm might come upon, while improving your processes at the same time.
- Accounts receivable is indispensable to your cash flow. If it’s disrupted because of claim denials, payor guidelines or AR concerns, we’ll delve into and sort out the problem, ensuring your company optimum cash flow. Keep in mind, our goal is to take the financial pressure off your company.
- Our staff stays up to date of all the changes in the business and we make certain the companies we bill for are continually informed and ahead of the curve at all times.
- We are readily accessible for inquiries from your staff via email, phone or fax. By offering various ways for you to make contact with us, we can furnish more rapid responses and make customer service more convenient for you.
- We furnish custom reporting. At a quick glance, you can understand precisely how your business is doing. We won’t inundate you in statistics but draw attention to important performance metrics.
- Our company is a one-stop destination providing across-the-board billing support at the best pricing levels in the marketplace. In brief, we completely take care of your billing. Your staff will not have to perform data entry, correct claims or call patients to collect money.
We know that our readers appreciate a 30,000-foot view of what’s in it for them as an DME business. So, here goes.
- Access to a highly trained and proficient team of professional experts in the DME market
- Substantial labor savings
- Prompt claims submissions
- Quick turn-around on denials
- Track and follow-up on partial payments
- Reduction in A/R days
- Reduction in bad debt
- Improved revenue, bill rates, collection rates and cash flow
- Superior quality and compliance
- Stringent audits and verification
- Proven track record in coding and billing
- Assistance with any type of DME billing problems
- Response to Medicare audit requests
- 100 percent HIPAA compliant
- Complete data security
- Customized reporting
Visualize your business on performance enhancing drugs or PEDs. (Please, figuratively, not literally!)
Picture it, operating capably and efficiently, with enhanced flexibility, improved compliance, and achieving financial excellence. That’s why you need to take into consideration outsourcing vs. in-housing specific parts of your DME business.
Keep in mind that billing can make or break your business. Whether you want to simply tweak your current methods or put new solutions into practice, you first must assess your existing DME billing processes. Are they triggering inefficiencies, backlogs or lost revenue? If so, you can boost your billing practices with a professional billing service.
When you’re ready to outsource your DME billing, be sure to select the right company to help guarantee your success and nail down maximized results. We do this well.