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Below are the key features that Rely On Us concentrates for increased revenue and decrease in AR for DME billing –
~ Fast forward eligibility verification process
~ Proactive prior authorization
~ Updated knowledge on coding and billing guidelines
~ Billing cost deduction of 70% and will improve your collections by 95%
~ An extensive Account Receivable recovery
~ No write offs or adjustments unless there is an approval from your end.
~ Provide you with the needed transparency and credibility
Durable Medical Equipment (DME) is equipment that withstands repeated use, is primarily and customarily used to serve a medical purpose and is covered by the insurances. Generally, DME is not useful to a person in the absence of an illness or injury and is appropriate for use in the home.
With increasing rents, salaries and lower reimbursement rates, DME business face shrinking margins.Lack of revenue oversight about the DME can end up in lot of money left on the table. The durable medical equipments are paid at different rates with various payors. Payer reimbursement knowledge is very essential for DME billing.
1. Verification of patient eligibility prior to patient check-in.
2. Documentation of the patient’s condition is crucial for DME billing.
3. We suggest appropriate documentation strategies at times of appeal. A good documented appeal process may help us get reimbursed.
4. A prescription and order of the DME must be issued and furnished to the suppliers within 45 days after the examination with the documentation which includes the patient’s medical record.
5. The coverage aspects of DMEs differ with each Medicare contractor, it is very essential to understand the Medicare regulations.
6. Since the introduction of competitive bidding of DMEs, physician must recognize of what DME can be employed to the patient as per the insurance eligibility.
7. Use of the correct codes with modifiers is very essential for the payment of the DME claims.
Rely On Us Healthcare Services as a competent DME billing company reduce your pain by following all the above mentioned steps. We take up the responsibility of reducing your billing costs by 70% and guarantee the excellent best practices.
Rental Tracking and Managements for DME: Many assume that the DME billing is the same as other general billing activities. It can be a lot more complicated than fill and bill. The rental orders are sometimes capped i.e. for a few months, it can be processed for 13 months, but from the 14th month, you must convert the rental to ownership and notify the customer. This includes good claims solutions too.
Understanding general payment rules : Guidelines for coding prefabricated Vs custom orthotics, following Local Coverage Determinations and National Coverage Determinations, appending appropriate modifiers required, frequency limitations, updates on the fee schedule, obtaining prior authorizations, General Documentation Requirements such as Written Order Prior to Delivery, Certificates of Medical Necessity, Evidence of Medical Necessity for Parenteral and Enteral Nutrition (PEN) Therapy plays a major role in increasing the payments and reduce denials.
Rely On Us provides end to end support for practice management / revenue cycle management that improves reimbursements with 100% HIPAA compliance. We believe in working as a one stop operational extension that can eliminate all the proven challenges that are faced with DME billing.
Adhering to the Timelines: Turnaround time is very essential for DME claims. Billing services promptly can increase the rate of reimbursement. Getting reimbursed gets harder every single day.
There exist many reasons for the denial of DME claims as stated above. Although physicians have the right to recommend the DME for their patients, yet without medical necessity, they may lose the reimbursements.
Payor rules and regulations change often and is very complicated. Our experts can help you get paid faster for the DMEs by setting up simple processes but efficient ways to keep reimbursements flow in.