Durable Medical Equipment (DME) is a complex specialty in terms of medical billing. A constant change in the regulations and guidelines is the reason for this complexity. Apart from that, improper handling of the medical billing process leads to slow revenue growth.
This compels healthcare providers to opt for better ways of managing medical billing and improving the workflow. Other than that, DME billing is challenging, and dealing with intricate codes can be a lot for healthcare providers. As a result, they resort to DME billing services that can handle medical billing and maximize reimbursement.
DME billing services provide a range of services and eliminate the burden on healthcare providers. There are also better results in terms of revenue and denials.
There are many benefits of medical billing services and healthcare providers must leverage them.
This blog highlights valuable aspects of DME medical billing and offers a clear roadmap for choosing the best services for your medical practice.
DME Billing – Explanation
DME medical billing is the process of getting reimbursed for the DME services rendered to patients. This involves completing the steps in the process such as coding, claim filing and submission.
DME is meant to provide therapeutic benefits to patients and is mostly applicable to long-term chronic ailments. There are many complexities in DME medical billing such as the extensive range of DME and the need for prescriptions before availing. Apart from that, not all insurance policies cover DME in their insurance coverage.
DME billing involves billing for equipment such as hospital beds, prosthetics, kidney machines, wheelchairs, walkers, nebulizers, oxygen equipment, crutches, and many more. Another essential detail is that DME billing is not issued for convenience, it is only available for certain medical conditions.
DME Coding – Explanation
Correct DME coding depends on the accurate usage of CPT codes along with HCPCS guidelines. This is directly related to preventing the denial of claims with accurate coding.
DME billing services work with a team of professional coders who are experts at handling the coding requirements of DME billing. They not only know the nuances clearly but also contribute to increasing the clean claim and revenue rate.
This is because proper translation of codes prevents denials and improves the financial posture of healthcare practices.
All the Steps in DME Claim Submissions
The steps in the process of medical billing are an integral part of ensuring that the practice achieves adequate revenue. All the emphasis lies on following every step carefully and with precision.
Following are the steps for DME billing:
- The first step in DME medical billing is documentation where necessary aspects are recorded. This further helps in translating that information into codes. The documents considered are medical prescriptions, proof of medical necessity, pre-authorization, and proof of delivery.
- The next step after documentation is translating that information into appropriate HCPCS Level II codes for claim filing.
- Once claims are filled out, they must be submitted to the insurance company within the deadlines. Being on time is essential to preventing claim denials.
- After submission, claims go in for processing by the insurance company, and upon completion healthcare providers finally receive adequate revenue.
- In the case of denials, the next step is proper denial management which identifies the root cause of the denial, corrects the issue, and resubmits the claim. This way, healthcare providers can reclaim the lost revenue.
These are the main steps in the process of medical billing and DME billing services follow everything step by step and derive results for the healthcare providers.
Getting a Hold of DME Billing Challenges
The challenges of DME billing prevent healthcare providers from getting their well-deserved reimbursement. That is why it becomes extremely essential to get a hold of these challenges for timely reimbursement and better financial results.
DME billing services are experts at doing this for healthcare providers as they provide a range of medical billing solutions. They aim to improve the revenue cycle and work to implement it. With medical billing services, healthcare providers have seen great results in their bottom line with decreased errors and increased revenue.
Here are some common complexities of DME billing:
Inaccurate Modifiers
Failure to pair the modifiers accurately is a valid reason for denial and rejection of claims. Appropriate modifiers are essential to achieving the desired financial posture. This is a major complexity that healthcare providers must prevent.
Omission of Information
Missing or inaccurate data can lead to further mistakes in claim filing. This makes it a considerable challenge that can lead to denials and revenue loss. As a result, healthcare providers cannot neglect the importance of collecting complete information.
Coding Errors
Just like modifiers, coding plays a major role in medical billing as well. At the time of claim filing, errors are a reason that further converts to denials. Healthcare providers need proficiency in coding, specially for the DME branch.
Benefits of Outsourcing DME Billing Services
Outsourcing medical billing services comes with many advantages for your healthcare practice and they are:
Reduction in Coding Errors and Denials
DME billing services are proficient in billing and coding. They understand all the challenges in the process of achieving adequate revenue and take steps to ensure accuracy. They maintain every step with precision resulting in a reduction of coding and errors. As a result, accurate coding prevents denials and contributes to the financial posture of your practice.
Improvement in Revenue Cycle
Revenue cycle management is the lifeline of any healthcare practice that functions and thrives when handled properly. Medical billing services are specially designed to address this need for healthcare practices. All their services are focused on improving the operational flow and streamlining the revenue cycle. They take care of every step in medical billing to maximize reimbursement and enhance the bottom line.
Complete Compliance with Regulatory Standards
DME billing services keep track of all the changes regarding regulatory requirements and make sure to follow all of them. The standards can be coding rules, data safety requirements, or other rules or policies. Staying current with the trends is necessary to keep the claims clean and ensure timely reimbursement as well. Medical billing services make sure to fulfill all the regulatory needs to improve the denial rate.
Conclusion
DME medical billing is complex and requires knowledge to be carried out successfully. For healthcare providers who are struggling with administrative tasks, DME billing services are a wonderful solution. Once healthcare providers shift to medical billing services there is no going back.
Why Choose Unify Healthcare Services
If you are looking for DME billing services, then Unify Healthcare Services is the right partner for you.
Unify Healthcare Services is a medical billing company in USA offering complete medical billing solutions for DME. They have a team of professional coders and billers who are proficient in handling the challenges of DME billing. They work to maximize reimbursement by improving the revenue cycle and workflow.
