n the DME revenue cycle management process, rejection and denials of claims can impact a lot in your cash flow and reimbursement rate. This is why it is extremely essential to recognize the reason of the denial details. Though denial of claims is part of the operation, however, it can be avoided if careful attention is given. This is why Sunknowledge is here to help.
The most common reason for DME denial:
Documentation problems –filing appropriate documentation for the prescribed DME product is extremely necessary and vital for not only just coder but also for billers. In order to justify claims when rejected or during auditing, the right documentation always helps. Not only putting the right product details is important but the detail of the patient, date, provider’s signature etc in the documentation process is also crucial; as without these the DME billing claims can be easily the reason for rejection or denial of claims.
Incorrect codes or modifiers – if a required modifier is missing or you end up with incorrect codes; the DME billing claims can be easily rejected. Thus it becomes very essential for codes to update the standard chart every week and also be efficient with all the current codes and changing codes to avoid causing mistakes. Appropriate codes and correct modifiers are always helpful with faster reimbursement as well.
Inappropriate Verification and eligibility – with in-house billers struggling to pass your claims in-between juggling administrative work and billing operation, they often miss out on the verification policy. Ensuring proper check of patient eligibility to proper check of coverage, spelling check is a responsibility which is where RCM organization like Sunknowledge fits on.
Sunknowledge helps you with better ROI:
Offering a sustainable and profitable DME billing process and workflow, Sunknowledge Services Inc is one of the best cost-effective RCM solutions in the US. Working on improving your operations, Sunknowledge experts constantly put an effort into closing the DME billing gaps not only faster but also efficiently. Transforming and redesigning your processes and organizational structure with complete billing software proficiency, our experts further help you with a reduction in operational cost by 80% decrease in your AR bucket by 30%, and a 99.9% proficiency rate.
In fact with timely claims submission and direct doctor office follow-up, our no-cost dedicated account manager are always focused on reducing your denial rate with -continuous follow-up, 24 hour turnaround time and working on improving your productivity metrics. Analyzing all your pain points, in this rising healthcare cost and changing healthcare regulations, we are here to help you in revenue generation. So if you are looking to improve your productivity metrics, Sunknowledge Services Inc is the ultimate solution.
