DME Billing Guidelines for 2019

In order to survive 2019 and get timely payments, DME providers will have to primarily focus on error-free coding. DME coding intricacies are deep rooted in HCPCS (Healthcare Common Procedure Coding System) Level II codes and policies by Medicare. Providers will have to hire DME coders who are experts at assigning the right HCPCS Level II codes for timely and error-free billing. They will have to have a good understanding of Medicare policies related to DME. Even the physicians will have to get a good understanding of their vital role in getting reimbursed for rendered services.

Focus on providing the right documentation

Each time coders will be using a HCPCS Level II code that ends in 99 (for instance E1399), they will have to provide supporting documentation with it. This is important because if Medicare receives a miscellaneous code, the claim gets suspended and concerning medical records are requested. These records are then checked for possible issues. The miscellaneous code is also reviewed to see if there is any other code that is more apt for the billing process.

So, DME billing demands top-notch coding because only experienced coders are aware of the appointed codes for most DME items.

Medical necessity

There will be a strong need to establish medical necessity of a DME device within the treatment episode. For instance, if a physician is ordering a wheelchair for a patient, it will be necessary to support it as a medical necessity. There are certain policies known as LCDs (Local Coverage Determinations) that are used for addressing necessary equipment usage. Knowledge of these policies will be needed so that the billers can avoid denials and receive proper reimbursement.

Top-notch billing

Streamlined billing service will remain a necessity in 2019 as well because obtaining reimbursement for DME is quite complicated. There are various reasons for this. For instance, from the DME reimbursement standpoint, if the reimbursement doesn’t form a complete treatment episode and just a part of it, the necessity of the treatment episode will depend on the recommendation of the physician. Due to this dependency, reimbursement for DME incidents gets complicated, requiring additional paperwork.

To get timely payments, DME billers will have to handle DME documentation effectively. They will have to have the expertise to handle reimbursement administrative activities starting from the identification of instances eligible for payment to claims preparation and submission.

About 247 Medical Billing Services:

We are a medical billing company that offers ‘24/7 Medical Billing Services’ and support physicians, hospitals, medical institutions and group practices with our end to end medical billing solutions. We help you earn more revenue with our quick and affordable services. Our customized Revenue Cycle Management (RCM) solutions allow doctors to attract additional revenue and reduce administrative burden or losses.

Contact: 
247 Medical Billing Services
Tel: +1 888-502-0537
Email: info@247medicalbillingservices.com

How To Find Effective DME Service Providers in 2019 with Accurate Medical Billing Services?

DME Billing is complex in nature- this is something that almost all practices dealing with durable medical equipment will agree with. Quite often, providers get substantial orders for supplies but they fail to recover the expected revenue due to inexperienced billing staff and their inability to work around an effective DME revenue process.

Error-free billing for durable medical equipment is critical because even if one medical device is billed incorrectly, it will result in a loss of thousands of dollars. Also, unlike most clinical procedures, DME billing suffers from various challenges. For instance, DMEs are mostly ancillary services and are often deemed as medically unnecessary. Also, at times, prescribed DME doesn’t meet the permitted reimbursement level and if there is a lack of HCPCS (Healthcare Common Procedure Coding System), then also timely payments become a challenge.

With the rise in the number of aging patients, market for durable medical equipment is expanding. It is also growing because patients now desire to stay in their homes. It is expected that the global durable medical equipment market will display growth by a CAGR of 6.14% during 2018-2023. But if effective billing practices are not in place, then getting paid will become a challenge.

Since DME Billing Service Provider has also been hit by regulatory changes such as the Final Rule, having a team of expert billers and coders has become a necessity. CMS has made it necessary to establish a prior authorization process for some orthotics, DMEs, prosthetics, and supplies under this rule. Now practice managers have to build a proper prior authorization process which is quite time-consuming. Complications involved in the creation of this process affect revenue generation and billing in a negative manner.

Considering the challenges 2018 is posing for DME Billing Services, seeking support from a professional billing company is the only hope. From navigating through difficulties in insurance approvals and permissible level of reimbursement to HCPCS, a reliable billing company will have the expertise and experience to help practices fight common DME billing challenges.

To maintain a steady cash flow, it is necessary to have an expert team that handles audits, claims submission, follow-ups and so on. By hiring a reliable billing partner, DME billing setbacks can be dealt with ease and billing costs can be reduced by 80%. Billing companies also ensure 100% HIPAA compliance along with offering monthly customized reports.

About 247 Medical Billing Services:

We are a medical billing company that offers ‘24/7 Medical Billing Services’ and support physicians, hospitals, medical institutions and group practices with our end to end medical billing solutions. We help you earn more revenue with our quick and affordable services. Our customized Revenue Cycle Management (RCM) solutions allow physicians to attract additional revenue and reduce administrative burden or losses.

Contact: 
247 Medical Billing Services
Tel: +1 888-502-0537
Email: info@247medicalbillingservices.com