A Guide on Durable Medical Equipment Billing

Medicines or other medical equipment’s can be readily available from a pharmacist, or any resources. But the pharmaceutical industry does not only rely on medications, right?

Often the patient’s health deteriorates to the extent that they have to rely on life-saving resources. But what exactly is a Durable Medical Equipment?

Durable Medical Equipment is the abbreviated form of DME. It is an item that is prescribed to patients who suffer from some severe medical conditions. Some medical conditions may weaken the body to such an extent, and they need a source to support their life. Such resources are termed as DME’s.

This Durable Medical Equipment is not cheap for many patients to buy. There is a considerable sum to be paid for even renting the item for a limited time, forget buying! Thus, for the patient to get some relief from the financial crisis, the insurance companies/payers may step in.

The insurance company pays a certain amount of claim, provided all the documentation and protocols set in place.

Durable Medical Equipment Billing is managing the overall activities that are taken place to claim for the equipment you rent. The documentation and every minor detail have to be clearly monitored as any misplaced document, or incorrect information can directly lead you to higher chances of denial for claims.

Durable Medical Equipment Industry

DME Industry is necessary, in all regards. When you look at medical history, so many patients suffer from chronic, life-threatening diseases. For instance, the entire world is right now shaken by the Covid-19 virus. There is an utmost need for the DME’s. When a patient is dying out there, is it necessary to treat them first or to have the documents sorted? 

For such instances, there’s a dedicated group of companies that will work on the complete management of renting or purchasing such equipment and helping the individuals gather the relevant data and papers which can help them to claim for such a tremendous amount. 

Also, it is your responsibility to look after your dear ones in such times and not indulge in some secondary affairs. These companies take up all your worry and liberate you from any possible issues. At the same time, making sure you’re not denied from the financial help you deserve. 

There are a lot of devices and equipment that fall under the Durable Medical Equipment. Few of the common and commonly heard are - Walkers, Crutches, Wheelchair, Hospital Beds, Oxygen related equipment, blood sugar monitoring, braces, mobility devices, ventilators, etc. While these are equipment that may not necessarily be purchased but rented for a specific amount, then, in scenarios like this- the billing and the proper coding is to be made sure. The claims will help the patient pay those massive heap amount.

Durable Medical Equipment Coding and Durable Medical Equipment Billing

Healthcare Common Procedure Coding System (HCPCS) is a standard code build for providers in the medical industry for health insurances and Medicare. The DME is a complicated procedure as compared to the other medical billing issues. This type of situations falls under HCPCS Level II codes. 

The Durable Medical Equipment billing is a procedure, and hence every step must be taken care of, failing, which can lead to a lesser chance of reimbursement. The code should be formulated perfectly, and the entities must be clearly and precisely defined. The information must be on point, and there is no space for any sort of ambiguity.

Multiple people come into picture while DME coding and billing process takes place. From doctors to the patient’s side, Durable Medical Equipment supplier and the coder to the insurance company. All must meet the ends to ensure that the patient is not incurred in debts or losses, the insurance company extends its support.

The entire procedure needs to be done in the proper flow. There is an algorithm that is usually followed for such systems. 

●       Once the doctor finds a requirement of any DME for a patient’s medical condition, the documents must be made which will help for claims submission.

●       Upon a request risen for DME, the patient’s end will reach out to a DME supplier. The coder here needs to provide the proper prescription and also collect the patient’s insurance company. 

●       The insurance company may also expect a check from their end. The use of the equipment and the agreement on paying for the equipment as the claim, all these sorts of business are settled here.

●       Upon finishing the necessary paperwork, the material is handed to the patient.

●       The medical coding is then done, the proper use of codes and the correct information is to be made. 

●       The entire procedure is encrypted in the code and handed to the insurance company. The appropriate authorization and billing are needed to ensure the insurance company is liable to pay the claim amount to the patient

There are a lot of services offered, like medical billing companies. They keep a record and check if all the documents are on point, and no incomplete or fake information is handed. The process is much complicated and tedious than expected.

The services obtained from a reliable medical billing company is utmost necessary in such regards. They take care and make sure all the documents are genuine, and all the paperwork is on point.

What Are Modifiers in Durable Medical Equipment Billing?

There is so much information related to any particular item. Any single code may not be sufficient to point out all the features and information. Hence, to have some extra information regarding the subject, modifiers are something to rely on.

From encrypting the information to giving the details needed for any particular Durable Medical Equipment, modifiers can be used with the HCPCS code. A modifier is used to provide more information. There are many keywords that are used but below mentioned are some of the widely observed modifiers.

●      RR – Rental

●      NU – New Equipment purchase

●      UE – Old Equipment Purchase

Even digging deeper, there are few other keywords that point out at the Rental period. For instance,

●      KH – First-month rental

●      KI – Second and third-month rental

●      KJ – Fourth to 13th-month rental

Outsourcing of Durable Medical Equipment Billing

It is beneficial in all regards to outsourcing DME billing and coding as it eliminates a lot of headaches and is a plethora of time-saving and cost-saving techniques. Instead of rubbing your heads on the documents and other sources, the doctors and health practitioners can concentrate more on the treatment of the patients.

●      The dedicated team is already skilled enough to deal with this and hence the time to train your staff or hire people to take care of these billing requirements.

●      The revenue can also be increased in terms of infrastructure and staff. With no need to hire more people and train them, this surely can be your brownie point.

●      The DME billing is time-consuming and tedious. It can end up taking a lot of your considerable time. This time can be productively used in taking care of the patients.

●      The billing stuff is trained and upgraded with the latest take in the market. They’ll be smart enough to tackle all the happenings in the market.

●      The reliable third-party sources will also make sure that the proper codes and accurate information is handed and nullifies the possibilities of generating errors. The work is done precisely and in the stipulated time period.

●      There is a lot of popular software available in the market that handles the task of DME billing. While the number may go on increasing, some very popular ones have been gaining a reputed position and are reliable for all sorts of DME Billing procedures.

Brightree is one of the most renowned and trusted software solutions for all your queries on Durable Medical Equipment’s Medical Billing. Helping you with all the steps, they have helped a handsome amount of people get their claims. From assisting you in generating revenues, they are one of the leading solutions.

Other widely used options are – Practice Suites, Provider Suite, Bflow Solutions. They are one of the most reliable and widely used software available in the market for billing of the durable medical equipment. They are used by professionals who ensure the complete management of billing these types of equipment and its uses.

Most Common ICD 1O codes used with Durable Medical Equipment Billing

There are few frequently used ICD 10 codes which target the problems coming under the Durable Medical Equipment Billing. Some of the commonly used ones are: -

●      E0100-E0159 - Walking Aids and Attachments

●      E0163-E0175 - Commode Chair and Supplies

●      E0181-E0199 - Pressure Mattresses, Pads, and Other Supplies

●      E0250-E0373 - Hospital Beds and Associated Supplies

●      E0424-E0487 - Oxygen Delivery Systems and Related Supplies

●      E0621-E0642 - Patient Lifts and Support Systems

●      E0950-E1036 - Wheelchair Accessories

In a nutshell

Durable Medical Equipment is used by healthcare professionals when there is a need for the patient to rely on some external sources to support his health and body. Such items bare a cost even if rented, hence there is a complete procedure to undergo for the perfect documentation and other paperwork.

Durable Medical Equipment Billing is often taken as a different department and several experts make the whole process by themselves. When the need arises for a specific Durable Medical Equipment, the prescription is taken to the Durable Medical Equipment supplier. This is coded in the proper format and presented to the insurance company.

Proper authorization check, if needed is done and the insurance company checks from their end. The entire documentation and paperwork are then handed to the insurance company and the claim can be generated.

A Durable Medical Equipment Billing is a tough task and hence the software or companies make sure to not indulge in any false or inappropriate information. Clear and concise data is to be given.

These types of services should not be constrained in any timeframes. The services should be made available 24*7 for fellow patients. After all, the need for a medical emergency arises at any odd hour. There is no advance notice or time limit for such cases.

Thus a dedicated team can take over these tasks to ensure that the work is done precisely and with no loss for the doctor in terms of time and money. Outsourcing the Durable Medical Equipment Billing & Coding is a suitable and well-chosen option.

Also, Credentialing services are time-consuming and may cost you high? Well, we are here to ease your troubles. Free Credentialing will be provided by us to cater all your needs and the services will not have you bang your head on the tiresome work. We are here to take care of the minute things that might have troubled you. Rely on our services as we offer you the best we can!

About 24/7 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:
 24/7 Medical Billing Services
 Tel: +1 888–502–0537
 Email: info@247medicalbillingservices.com

Error-free Billing for Durable Medical Equipment in Michigan

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.

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. To maintain a steady cash flow, it is necessary to have an expert team that handles audits, claims submission, follow-ups and so on. DME billing setbacks can be dealt with ease and billing costs can be reduced by 80%.

By hiring a reliable billing partner, Billing companies also ensure 100% HIPAA compliance along with offering monthly customized reports 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.

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.

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 24/7 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:
 24/7 Medical Billing Services
 Tel: +1 888–502–0537
 Email: info@247medicalbillingservices.com

Best DME Billing Services in California, USA

DME Service Provider, if you are investing in a DME billing software to reduce paperwork, cut down expenses and get payments on time. 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.  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.

If you are planning to invest in a DME billing software, then here are a few benefits that you will get to enjoy:

·       Save time and money:

With 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.

·       Efficiency:

Entering medical data is a tedious and time consuming procedure but with 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.

·       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.

·       Timely reimbursements:

Whether it is 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 billing software, there is no room for incorrect data entry which leads to full and timely reimbursement for the services offered.

·       Thorough documentation

Another benefit of using 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 invested a lot of time. But this process can be completed faster and easily with software. The software will find relevant documents, make copies and even send it to all the related parties.

About 24/7 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: 
24/7 Medical Billing Services
Tel: +1 888-502-0537
Email: info@247medicalbillingservices.com

Why Outsourcing your DME Billing Services is the Best thing?

There are several complications involved in the process of obtaining payments, from validation of the patients to getting authority beforehand, use correct forms to submit the claims, etc. A complicated procedure like DME billing (Durable medical equipment) will be very challenging for anyone unless they assign professional billers and coders to do it for them.

Several different scenarios can require the DME billing services to be dealt with by an in house team or outsourced to a professional medical billing services company, and those reasons vary with each having its perks for different reasons. Apart from the other skills, it requires the person to have a profound understanding of the reimbursement protocols for all the services provided.

A skilled DME billing service company or in house team should be able to double-check on document collections, incomplete prescriptions, verification of insurance on rental items, handle real-time transaction audits, verify primary and secondary insurance, HIPAA compliance, etc.

Some of the other leading obstacles that are involved in getting DME reimbursement is because they don't develop a complete treatment happening. It would only be a fraction of the procedure and their requirement banks on the doctor's recommendation. 

Outsourcing or in house team?

If you run a small private clinic or are an independent physician, then customized outsourcing of the billing services is the ideal option to get the best possible option for you. However, if it's a large clinic or hospital, then it's essential to have an in-house team as it is crucial to keep it up to date regularly for a big institution.

By outsourcing the process, you make it easier on yourself in the long run as they are professionals who have teams with professional billers and coders who have detailed insight on the documentation requirements for DME.

They would also be able to provide consistent services in terms of quality regardless of the fluctuations happening in the industry regarding the changes in reimbursement regulations, documents, etc. and would assist with the complete reimbursement for the executive activities.

Outsourcing services also provide all the information from the identification of available insurances for reimbursement to preparing the claims and submitting them in time. Along with providing these services, they could also assist you with developing some physiological explanations of the disease, impairment, injury, etc. and the reasons for using specific equipment for that particular ailment.

Outsourcing companies for DME billing services prepare the claims, along with valid codes, submits them, and follow it up with the insurance providers to ensure that you get paid on time. It also helps you and your employees to concentrate on the critical medical operations that you need to take care of without worrying about the billing and collection aspects.

They work on all the necessary procedures and software complexities to prevent it from leading to denials of the claim, and they also make sure that they streamline the billing process for you.

If you have a small clinic or are an individual practitioner, then it's more beneficial to get a professional to outsource your DME billing jobs to as they'll be able to create custom strategies for your business to get the best possible outcome.

An in house team can be important for larger medical hospitals that have various departments of specialties and a substantial amount of complications regarding the DME billing processes because they don't have to pile up the work to get it outsourced and it can be completed then and there.

With an in house team, you'll be able to file the documentation quickly simultaneously without any delay or significant mistakes with the information as it's obtained directly from the source. It's easier to check up on incomplete prescriptions and bills if the team is in the hospital itself, and this way, it reduces the risk of any errors that would lead to denial of the claim.

However, to get the best possible results, you must make sure that you hire competent individuals who are experienced and can do the job correctly. Regardless of what option you choose, both those options should be able to track and follow up on the incorrect or partially correct payments, provide a highly error-free transaction, denial management, customized reporting, etc. So, in the end, it all depends on what is the most appropriate option for you and your practice.

About 24/7 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: 
24/7 Medical Billing Services
Tel: +1 888-502-0537
Email: info@247medicalbillingservices.com