Medical billing for DME (Durable Medical Equipment) can be quite labor-intensive and time consuming. It is very important that DME providers have a team of expert billers who have a detailed understanding of reimbursement guidelines specified by Medicare, Medicaid and commercial plans.
Here are some of the challenges that DME providers face:
- DME is considered therapeutic services
- Some DME services are unauthorized by Medicaid, Medicare and private health insurance plans
- There is lack of a strong founding in the HCPCS (Healthcare Common Procedure Coding System), which represents Level II codes that are assigned for DME supplies and gears
Another very common challenge with DME services is related to medical necessity. Doctors can prescribe DMEs as a part of their clinical treatment process; however, they need to back it with a proposal along with sufficient verification to prove their medical necessity.
It is very important for DME providers to have a streamlined coding process. If there is lack of a strong grounding in the HCPCS, overseeing level II codes for DME equipment and supplies, then it will lead to the doctors’ less than impressive acknowledgement of DME bills.
In order to overcome challenges in DME billing, many providers choose to outsource this service. Letting a reliable billing company handle DME coding has its own benefits. Here are a few:
- Outsourcing gives the provider access to a team of highly trained and experienced billers and coders. This team is well-versed in the latest regulations and requirements due to which DME revenue gets a boost.
- Since a dedicated team handles revenue-related tasks, labor costs get reduced to a great extent. There is no need to hire in-house billers and coders and pay them salaries or employee benefits. Even the cost incurred on infrastructure and technology gets eliminated.
- Outsourcing gives peace of mind and enough free time to focus on other vital tasks. Providers don’t have to worry about HIPAA compliance because a reliable company will ensure compliance in their services. They will keep data confidential and not let any security breach happen.
- Providers don’t have to worry about transparency in the billing procedure because a good billing company will provide timely reports. The team will be able to explain statements in a better manner along with handling complaints and addressing issues. This will help in improving patient satisfaction to a great extent for the provider.