The DME billing procedure is entirely different than that of the other medical billing and coding processes. DME has been classified under the HCPCS level II codes. These codes are of 5 digits and come in a combination of alphabets and numeric. Adhering to these codes requires domain-specific expertise. There are multiple steps involved in coding the DME billing. The process consists in getting the prescription from the medical practitioner, assigning the codes, and processing the billing for claims from the insurance payer. Finally, getting it distributed to the patient.
What are the Rules & Regulations that can Impact the DME Medical Billing Process in 2021?
Do you know that COVID-19 has not only brought medical emergencies worldwide but also impacted the DME Suppliers by waiving off certain requirements?
These rules and regulations have changed the entire outlook of the DME Medical Billing Process as impacting the DME suppliers would mean directly affecting the DME Providers. This has led to the Medicare and the Medicaid Services updating their rules in April 2020 that are pertinent to the Medicaid and Medicare policies.
While these policy changes equipped the US healthcare system with the much-needed flexibility to respond quickly to the pandemic, they also impacted the DME Suppliers. The suppliers execute the claims submission process and get the authorizations that are integral parts of a DME billing process. The regulations that affect the suppliers, therefore, have a consequent impact on the overall billing process. This is why it is a necessity to outsource the DME billing process to external professionals.
Let’s look at a few of the waivers that are about to impact the DME billing process in 2021.
- Requirements like face-to-face interaction along with the recommendation from the doctors about the requirement of the DME equipment for the DME replacement item are waived off. DME suppliers must describe the replacement claim and document the loss or damage of the equipment. This requires time for suppliers to complete the procedures that can impact the regular DME billing process.
- The new requirement does not need the patient signatures and proof of delivery notes to abide by the no contact policy for the pandemic outbreak. Because of the pandemic, the suppliers must note the DME equipment delivery date and mention the inability to get the patient’s signature. These are additional steps along with the regular DME billing process.
- Under the Coronavirus Aid, Relief, and Economic Security (CARES) Act, CMS will ensure higher payments for specific DME equipment in classified areas like non-rural and non-competitive bidding within the US pandemic period.
What are the right moves to outsource the DME billing in 2021?
The brighter picture amidst the Covid-19 pandemic has cleared the dilemma that has plagued the question about outsourcing the DME medical billing by the healthcare practices. In-depth knowledge about Medicaid, Medicare, out-of-pay, and other industry mandates is not enough for DME billing. The dynamics and the changing regulations in the healthcare sector will require special expertise in the DME billing process in 2021.
Let’s have a look at the different factors that will help you in making the correct decisions about outsourcing the DME billing in 2021:
Robust Technology Infrastructure
An immediate requirement is to have faith in the latest technological innovations that can help you speed up the DME billing process. This can compensate for the time taken additionally for aligning the billing process to the present regulatory framework. However, as a healthcare practice, investing and train your employees on the latest technologies can be an added burden, especially during this Covid-19 pandemic. Thus, outsourcing the DME billing process to third-party vendors with the appropriate technology infrastructure and expertise to execute the process seamlessly is even more relevant.
As an emergency Covid-29 outbreak, most hospitals in the US suspended their non-emergency medical care. This resulted in more than USD200 billion losses within four months, as per the estimation by AHA1. Stepping into 2021, it is crucial to partner with a DME billing service vendor to reduce the overall operational expenses. An experienced vendor will provide accurate reporting that will showcase the areas of improvement in the DME billing process. These will minimize billing errors and increase the prospects of saving costs.
It’s Time to Increase Your Revenue..!
Are you already super busy with managing your DME supplies? Have you started feeling drained from doing the medical tasks on your own? No one can ignore the fact that medical billing errors have a direct impact on reimbursements. Simultaneously, there is a complexity in generating and collecting the revenue. The best and one-stop solution to all your medical billing-related problems is the 24/7 Medical Billing Services. Call our experts immediately to enhance your revenues more than ever.