What exactly is a
Durable Medical Equipment?
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 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 checks, 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
24/7 Medical Billing Services is the
nation’s leading medical billing service provider catering services to more
than 43 specialties across the entire 50 states. You can rely on us for
end-to-end revenue cycle management. We guarantee up to 10-20% increase in the
revenue with cost reduction of your practice for up to 50%. Call us today at
888-502-0537 to know more on how we can help boost profitability for your
practice.
Media
Contact –
Hari Sudan, Media Relations,
24/7 Medical Billing Services,
16192 Coastal Hwy,
Lewes, DE – 19958
Tel: + 1 -888-502-0537
Email - info@247medicalbillingservices.com
Website – www.247medicalbillingservices.com
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