Last Updated on August 26, 2021 by Editor Team
Unpredictable revenue leakage has become one of the major headaches for healthcare providers, who are improving patients’ lives by using durable medical equipment. The major reason behind the constantly declining reimbursements is the high percentage of denied/rejected claims. However, you can plug the revenue loss and keep your claims process right by implementing the right solutions to streamline the DME billing services.
In this challenging era, where uncertainties are moving around the healthcare industry, it has become extremely challenging for medical practitioners to keep their business financially successful.
Those who are already losing their hard-earned revenue due to the inefficient billing system, look for innovative DME billing solutions to increase the productivity of their business.
Moreover, it has been observed that healthcare practitioners see a big difference between the amount they mention in a medical claim and the amount they receive as a reimbursement. Underpayments are another major obstacle in achieving financial goals.
It’s always been the case for DME billing and coding. Furthermore, the medical billing and coding for DME related healthcare services are extremely complicated. It requires greater attention to prepare accurate documentation to justify the use of durable medical equipment.
So, relying on inexperienced staff for revenue cycle management can result in negative consequences i.e. an excessive number of claim denials. Ultimately, the frequently denied/ rejected claims cause revenue loss and impact your practice’s financial stability & success negatively.
In such circumstances, outsourcing DME billing services come into play. It enables healthcare providers to cut the extra costs and collect the maximum revenue for the medical care provided to the patients. Outsourced DME billing experts collect every single dollar on your behalf. They not only prevent future claim denials but also reduce the medical accounts receivables to help you to reach your revenue goals faster.
What is DME?
Before diving into further discussions, it’s pertinent to have a clear understanding of what DME actually is?
Durable Medical Equipment (DME) is aimed at extending therapeutics relief for patients with a long term critical condition. DME can include; walkers, wheelchairs, oxygen tanks, CPAP, Nebulizers, kidney machines.
How Can Outsourcing DME Billing Benefit Your Practice?
As we have already discussed, outsourcing the DME billing service always comes with immense benefits. Here are the following reasons that justify the fact that it can be very beneficial for your practice in the following ways:
Ensure Accurate Medical Coding
Medical coding errors such as; incorrect, mismatched medical codes for the accessories and equipment are the major reasons for claim denials.
Because insurance companies only pay after getting the complete information about a particular injury, diagnosis, treatment, medical services and equipment used while providing healthcare to the patients.
So, using the wrong HCPCS codes for DME can lead to hard denials. As a result, healthcare providers can lose reimbursement for a long time period and in some cases permanently.
However, by outsourcing DME billing services, you no longer need to worry about finances as well as compliance issues. Because outsourced medical coders are certified and well versed with in-depth knowledge about the coding classifications i.e CPT, ICD-10 and HCPCS codes.
They use the right diagnostic and procedural codes for the healthcare services a patient received during his/her visit to your medical facility. Which ultimately eliminates the major coding errors like; unbundling, upcoding and under-coding. As a result, medical practitioners always get the right amount in their accounts and can save their practice from legal issues too.
It’s pertinent to mention here that the most common HCPCS codes for the DME billing services are:
- E0100-E0159: Walking Aids and Attachments
- E0160-E 0162: Sitz Bath/Equipment
- E0163-E0175: Commode Chair and Supplies
- E0181-E0199: Pressure Mattresses, Pads, and Other Supplies
- E0200-E0239: Heat, Cold, and Light Therapies
- E0950-E1036: Wheelchair Accessories
- E0700-E0710: Safety Devices
- E0720-E0770: Stimulation Devices
- E0776-E0791: Infusion Pumps and Supplies
- E2402-E2402: Wound Therapy Pumps
- E2500-E2599: Speech Generating Devices, Software, and Accessories
Prepare & File Clean Medical Claims
It has been estimated that the healthcare sector loses approximately 20% of its revenue just because of claim denials. A claim gets denied or rejected due to the certain reason such as;
- Incorrect demographic information about the patients.
- incorrect medical codes, modifiers or missed PIN or NPI.
- Submission of duplicated medical claims.
- Lack of prior authorization.
- Failure to keep up with the given time frame of the insurance companies.
However, preventing claim denials is one of the major driving factors that inspires healthcare providers to outsource their DME billing services to a professional billing collections agency.
Outsourced DME billing specialists gather all the required documents and continue the process of claims preparation. They are more knowledgeable about the latest guidelines set by the payers or regulatory bodies. Which enables them to prepare and file the medical claims as per industry standards.
Moreover, in order to get paid faster, they make sure that:
- They do not cost the rent of DME more than the actual price of that particular equipment.
- Timely file the medical claim to collect the rent for DME.
- Charge rent for DME to patients on a daily or monthly basis.
- Patients’ information such as: name, gender, age, date of birth is accurate and updated.
Hence the efficient management of medical claims prevents the claim denials and ensures timely reimbursements.
Ensure Consistent Cash Flow:
Outsourcing DME billing services always results in maximum revenue generation. For instance, in this way, medical practitioners can save a significant amount of money on overhead costs.
That includes the hiring, training, incentives, higher salaries of the professional billing staff. And more importantly the purchase as well as maintenance of the innovative billing software/hardware. Saving money on operational costs reduces the financial burden of healthcare providers.
Additionally, outsourced billing services add value to your healthcare business by preventing claim denials, reducing days in the medical accounts receivables and improving your billing collections.
Compliance and Data Security
Off-shore DME billing companies are legally responsible to secure your highly confidential health information from mismanagement, theft, cyberattacks or other fraudulent activities. For this purpose, they use secure medical billing processes and technologies to safeguard your company’s and your patients’ data.
In addition to this, they help you to keep your administrative workflows compliant with HIPAA and other federal regulations.
Are you striving to make your healthcare business profitable? Then outsource your DME billing services to the Medcare MSO. We are the leading medical billing service providers in the United States. Our experts provide customized solutions according to your speciality needs to elevate the revenue collections for better financial health. Pay a visit to our website to get detailed information about our services.