Billing Companies Helping Pharmacies with DME Billing

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

Ensuring a Profitable DME Business in 2019

In order to receive timely payments, it has become imperative for DME suppliers to demonstrate medical necessity of the durable medical equipment. Without securing and retaining the right documentation of medical necessity, obtaining Medicare payments can become a nightmare for those involved in furnishing DME and submitting claims.   

All this has pushed the need to have expert billers and coders who are aware of the Medicare regulations and ICD-10 coding changes.

DME Code Changes

Here are some of the April changes to the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) items and services.

Centers for Medicare and Medicaid Services (CMS) has not only added a diabetes code but also changed oxygen coding for the DMzcxE fee schedule by altering the HCPSC Level II modifiers.

Diabetic DME codes- there have been some changes that will affect coding of HCPCS Level II code K0903. According to the CMS, the fees for K0903 are set on the basis of fees for code A5513.

CMS released the DMEPOS fee schedule for 2019 that will be effective for Medicare claims that have a service date on or after 1st of January. Also, according to the AOPA (American Orthotic and Prosthetic Association), in 2019, the  Medicare Fee Schedule for O&P services will also increase by 2.3% compared to the rates in 2018.

Surge in demand for trained coders

Coders need to pay close attention to the details of doctor’s procedures and diagnoses. They will have to use very specific ICD-10 and CPT codes to get reimbursed. For instance, if they are using billing diagnosis code F11.20 on a claim with procedure code 80307, it will reimburse them about $30 less than specifying the exact opioid being used by the patient.

To get paid on time, many suppliers have started outsourcing their billing needs to a third party. Outsourcing is giving them the opportunity to get reimbursed on time, without having to go through the hassles of keeping up with coding and regulatory changes.

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

DME Billing Software to Automate your DME Billing

Error-free DME billing is necessary for continued successful operations. Since it is a time consuming and tedious process, health professionals are choosing to automate medical billing. They are investing in a DME billing software to reduce paperwork, cut down expenses and get payments on time.

Medical billing software can be of great help in managing the financial information and streamlining the billing and coding procedure. If you are planning to invest in a DME billing software, then here are a few benefits that you will get to enjoy:

Efficiency

Entering medical data is a tedious and time consuming procedure but with a billing software you can improve efficiency and reduce errors in data submission. Once the patient data is uploaded in the billing software, it becomes easy to transfer the data between systems in a seamless manner. This saves a lot of administration time and effort, resulting in improved efficiency.

Save time and money

With a quality DME billing software, you can save time as well as money in different areas. For instance, it helps in reducing the administrative workload, eliminating the need to hire more staff. Since things are automated, less paper is used which cuts that expense and also reduces the time required for monitoring it.

Timely reimbursements

 Whether it be ICD-10 codes or the background data for patients, incorrect data entry can lead to low reimbursements. Even the most dedicated employee can end up making occasional mistakes in data entry and this can cost you a lot of money. But if you are using a billing software, there is no room for incorrect data entry which leads to full and timely reimbursement for the services offered.

Ease in reporting

 New avenues of reporting can be opened up if billing and documentation is linked. For instance, if there is better access to information, healthcare professionals can easily determine the procedures that are losing money. They can then take necessary measures for closing the financial gaps. When every process is integrated, the process of making inferences from one side to another becomes easier.

Thorough documentation

 Another benefit of using an integrated software is thorough documentation. For instance, a chain of documentation is required for claims forms, especially when it is related to a workman’s compensation. In order to hunt down the forms, the administrator needs to be invest a lot of time. But this process can be completed faster and easily with a software. The software will find relevant documents, make copies and even send it to all the related parties.

So if you wish to devote more time on patient care and less on billing and payment challenges, then an integrated DME billing software is just what you need.

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

Staying in DME Business with Effective Billing Services

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.

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.

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.

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 involve in creation of this process affect revenue generation and billing in 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.

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