Several measures are being taken by the US healthcare industry to reduce costs and this has hit DME providers really hard. While they are being reimbursed by Medicare Advantage plans at a lower rate than other plans, growing financial responsibilities are also adding to the pressure. Due to these challenges, DME providers across the US are finding it hard to collect more and maintain a steady cash flow.
Here are a few opportunities or ways in which DME providers can protect their bottom line for the coming months:
- Denial management is one of the most effective ways in which they can keep their business running. Nearly 90% of denied claims are avoidable, so they should hire experienced billers to help them get paid on time. By having expert staff, they will be able to proactively address the reasons for denials.
- By changing the denials workflow, providers can benefit tremendously. For instance, when denials occur, offices choose to rework on the ones with the highest value. Due to this, they leave smaller denials that can add up to thousands of dollars in missed revenue each year. So reworking needs to be handled in the right manner, facilitating faster resubmission and reimbursement.
- Pricing transparency will have to be improved if DME providers want to survive in business. This is necessary because now patients are responsible for more of their healthcare costs and they expect transparency in services as well as devices. It is important to ensure that the patients know what they will pay towards the cost of the product and what they will owe. Doing this will not only help the providers know the information needed to ask for full payment at checkout but also help drive collections? It will also help in improving patient experience.
- To accelerate reimbursement, DME providers should also make payment easier for patients. This is important because patient payment comprises of a great portion of any healthcare organization’s revenue. So if there are any obstacles that can impede a patient’s ability to pay, then they should be removed. Since most of the DME equipment that patients either buy or rent is expensive, it is important that they have enough options to make payments.
There is no doubt that reduced payer reimbursement and higher patient-financial responsibility is here to stay. So DME providers need to be prepared to offset the impact on their revenue cycle.