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.
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. In order to
survive 2019 and get timely payments, DME providers will have to primarily
focus on error-free coding.
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.
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
Contact:
247 Medical Billing Services
Tel: +1 888-502-0537
Email: info@247medicalbillingservices.com