Practice
is purchasing DME in hopes to receive a profit in return. Since durable medical
equipment isn’t professional services, this poses challenges in obtaining
payments.
To
ensure that DME claims from your offices are being submitted on time and with
accuracy, it is necessary that you hire billers and coders who are abreast with
the CMS rules and regulations. If they are using wrongly coded modifiers, they
will have to face a hit on profits.
Medicare
and several other commercial carriers continue to scrutinize Durable
Medical Equipment billing. This has pushed the need to understand and
follow DME documentation requirements. If your billers fail to do so, it will
not only put your office at risk of an audit but also result in refunding an
insurance carrier or CMS which means unnecessary loss of revenue.
Some common errors that
result in DME claim denials are:
•
Lack
of patient data verification is a common reason. If there are small errors in
names or the way forms have been filled, then claims get denied either by the
CMS or the insurance provider.
•
Another
common reason is errors in coding. If your billing staff is submitting medial
documentation indicating different codes other than the one billed, the claim
will get denied.
•
It
is important that the documentation shows that services billed were medically
necessary as per the policies of Medicare coverage and payment.
•
As
mentioned-above, lack of sufficient documentation is a huge reason behind DME claim
denials. If there is
no proper documentation, it becomes difficult for coders and billers to put in
the right information. All this will lead to a negative impact on cash flow and
also result in wastage of time and effort.
Correct
documentation is extremely important for DME. Attention needs to be paid when
documenting and data should be rechecked before it is streamlined to coders and
billers. Documentation needs to prove that the billed services were actually
provided. In case of an audit, if it is found that you don’t have proper
documentation, your practice will have to give that money back and also face
penalties.
Considering
the challenges in DME billing and the
complexities involved, many providers choose to hire a third party for billing.
Outsourcing their billing needs gives them access to a team of skilled coders
and billers who work dedicatedly to bring timely payments for their clients.
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
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