Today in this corona virus pandemic crisis healthcare providers are suffering the most in providing a seamless medical billing process for orthotics and prosthetics, HME, DME billing etc.
This is because healthcare providers, labs, diagnostics centers are not only striving to keep up with testing demand but also struggling in affording protective equipment for the front-line health workers.
In fact, it is confronting challenges like stock chain disruptions, shortage of proper resources, patient financial responsibility, medical supply deficiencies, improper DME billing and collections etc.
What are DME and DME billing and collection?
DME or Durable Medical Equipment is any medical equipment that is prescribed by licensed physicians to patients so that they can serve a better quality of living, especially those who are suffering from certain medical conditions or any sort of illnesses. This includes nebulizers, CPAP, wheelchair, oxygen tents etc. However all these Durable Medical Equipment has to go through a billing and collection process once acquired by patients is known as DME billing process. In fact, here are the few steps that will help you understand the DME billing and collection and how does it work.
New patient Entry- this step involves entering every detail of the new patient to ensure a seamless DME billing and collection process. The information which is collected includes the name of the patient, patient’s Date of Birth, ordering provider’s name, NPI, Tax ID, address, phone no along with insurance information. We also ensure a proper check on every detail to eliminate fatal and non –fatal documents errors.
Medical Coding – proper check on the diagnosis code is done with experience coders with complete HCPCS Level II codes knowledge, units for each service code etc
Eligibility and Benefits Verification- here the documents undergo stringent checking of all the information that is been provided and then involve providers and insurers to ensure that your client is eligible for claims. Also if the claims have coverage benefits or not etc.
Prior Authorization – it is the most heretic work in the DME billing and collection process as this authorization process can sometimes lead to three business days to five.
Claims Submission- once all this is finished the claim is submitted about the Durable Medical Equipment that is purchased by the patients.
Rejection Management- Here it is a part of the DME billing and collection process where the claims that do not meet specific data requirements or basic formatting requirements and hence rejected, affecting healthcare reimbursements. Rejection Management plays a vital role in the DME billing and collection process. As even a single error and can have a significant, negative impact on your overall revenue cycle.
Payment Posting- posting of the payments instantly into the respective patient accounts, against that particular claim to reconcile them.
Accounts Receivables Follow-up – this is when claims filling is done a follow-up with the insurer to inquire about the state of claims submission begin.
Denial Management – is when the identification of the errors in the DME billing and collection are corrected to reduce future denials.
However, as the DME billing and collection is a vast area to deal with and in this period of corona virus crisis, where healthcare providers are facing numerous challenges including shortage of experience billers and coders for DME billing process. Outsourcing your DME billing and collection process is the best option. As few outsourced medical billing organization is not only helping in reduction in your operational cost by 70% immediately but also, providing you with a FREE Telemedicine platform to increase the volume of your patients intake.
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Photo courtesy of: Patch
Originally Published On: Patch
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