The industry of Durable Medical Equipment (DME) billing changes its regulatory compliance constantly, making it difficult for providers to stay up-to-date. As 2022 will see more changes and additions in the billing system, it is important to focus on minimizing the errors, staying updated with the latest regulations, and following an efficient billing process. The final focus is to improve customer service by avoiding mistakes and reducing costs.
What is DME Billing and How is it Different?
DME billing is used to bill medical equipment like canes, walkers, hospital beds, standing frames, infusion equipment, bathroom equipment, pneumatic compressors, trapeze equipment, and other accessories.
The operational requirements of DME billing keep changing, and the process has strict regulatory scrutiny and tight credit markets.
DME billing needs in-depth knowledge of all HCPCS Level II codes and an understanding of the complex procedure of reimbursement. The providers need to know how to code claims properly as DME includes renting equipment more than purchasing. The codes are specified to the equipment rather than the procedure like in other types of billing.
Strategies & Tips for Efficient DME Billing in 2022
Follow the Process
Firstly, understand the process correctly. A doctor prescribes medical equipment to the patient. The reasons of medical necessity will be needed as a document while claiming. The patient then goes to the DME supplier. A coder needs to get the provider’s prescription, the patient’s insurance, and the billing information. Pre-authorization may be needed, depending on the patient’s insurance. The insurance company first reviews and verifies the diagnosis and treatment, and only then is the equipment approved. After the whole paperwork is done, the equipment is handed over.
Proper Validation of Insurance
Validate the insurance before the scheduled appointment day. This ensures you can make changes to the policy, if any, in time. You may verify the insurance by calling, validating the coverage with online resources, or using EMR for verification. If the equipment/service is not covered in that insurance, it can lead to payment delays.
Collect Fees Upfront
When any equipment is provided, ensure that the co-insurance and co-pays are also collected. Maintain a good check-out process that also checks past dues or deductibles. Hence, the collection of fees is done before the patient leaves.
Minimize Coding Errors
Use of correct codes and billing the claim to the insurance company is also important. Make sure each and every piece of the equipment or accessory is billed and coded for. Several providers have lost reimbursement amounts only due to errors in coding. All staff that handles coding should keep a track of ICD-10-CM, CPT-4, and HCPCS coding.
Handling and managing so many documents can be a task and may invite errors. Haphazard ways can result in data loss or incorrect entries and then claim denials. Form a good document management system ensuring efficient organizing, storing, and retrieving of information. Scanning documents and making them digital can help in effortless viewing or sharing without any fuss.
Take extra care and protect the information of each client. Ensuring data safety is of utmost importance. The staff members should coordinate with each other concerning information access and performance accountability.
Use the Latest Systems for Better AR Management
Achieving a higher DME revenue cycle is only possible when there is effective AR management. Get rid of out-dated AR applications and bring in the application with updates and changes in the healthcare industry. Rely on EMR (Electronic Medical Records) to
manage patient data, follow-ups, claims, and reimbursements. It can help automate patient collections and simplify billing and coding.
Stay Updated with the Regulatory Challenges
These challenges are constantly changing, and all staff must adhere to them for proper reimbursements. Always maintain routine compliance audits to keep track of everything new and correct the errors happening frequently.
Proper Claim Management
Alert applications, automation in EHR (Electronic Health Records), and a digital management system can help handle the claims effectively. The claims management process should be maintained for an effective workflow. Correcting and following up on rejected claims is necessary to keep the reimbursements coming. The more successful claims are, the more financial stability your business gets.
Outsourcing to the Rescue
Outsourcing can be a great solution to all the challenges you face in DME Billing. A team of experts that regularly updates themselves with all the new rules and regulations can effectively manage you’re A/R collection process and make sure the reimbursements keep flowing in without rejections. Outsourcing can also help you focus on a good customer experience. With constant automation, reiterate the importance of human emotion.
Outsourcing your DME Billing to 24/7 Medical Billing Services can help speed up your practices and get higher revenues in 2022. We are HIPAA-compliant with a team of experts that can help you with a reliable DME billing service.
Read more: All About DME Billing Services