2022 Strategies For DME Billing Services

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2022 Strategies For DME Billing Services

The industry of Durable Medical Equipment (DME) billing changes its regulatory compliance constantly, making it difficult for providers to stay up-to-date. As 2022 will see more changes and additions in the billing system, it is important to focus on minimizing the errors, staying updated with the latest regulations, and following an efficient billing process. The final focus is to improve customer service by avoiding mistakes and reducing costs.

What is DME Billing and How is it Different?

Medical equipment billing is used to bill for medical equipment such as canes, walkers, hospital beds, standing frames, infusion sets, bathing sets, pneumatic compressors, trapeze sets, and other accessories.

The operational requirements for medical equipment billing keep changing, and the process has strict regulatory scrutiny and tight credit markets.

Durable medical equipment billing requires a thorough knowledge of all Level II HCPCS codes and an understanding of the complex reimbursement procedure. Providers must know how to code claims correctly, as durable medical equipment includes equipment rental rather than purchase. The codes refer to the equipment and not the procedure, as in other types of billing.

Strategies & Tips for Efficient DME Billing in 2022

Follow the process

First of all, you must understand the process correctly. A physician prescribes medical equipment to the patient. The reasons for medical necessity will be required as a document when claiming. Next, the patient goes to the medical equipment provider. A coder needs to obtain the provider’s prescription, the patient’s insurance and billing information. Prior authorization may be needed, depending on the patient’s insurance. The insurance company first reviews and verifies the diagnosis and treatment, and only then is the equipment approved. Once all the paperwork is completed, the equipment is delivered.

Proper insurance validation

Validate insurance prior to the day of the scheduled appointment. This ensures that policy changes, if any, can be made in a timely manner. You can verify insurance by calling by phone, validating coverage with online resources, or using the EMR for verification. If the equipment/service is not covered under that insurance, it may cause delays in payment.

Collect fees in advance.

When any equipment is provided, make sure coinsurance and copays are also collected. Maintain a good checking process that also verifies previous fees or deductibles. This way, the collection of fees is done before the patient leaves.

Minimize coding errors

It is also important to use the correct codes and bill the claim to the insurance company. Be sure to bill and code each and every piece of equipment or accessory. Several vendors have lost reimbursement amounts due to coding errors alone. All personnel handling coding should keep a record of ICD-10-CM, CPT-4 and HCPCS coding.

Document Management

Handling and managing so many documents can be a chore and can invite errors. Messy forms can result in lost data or incorrect data entry and, subsequently, claim denials. Form a good document management system that ensures efficient organization, storage and retrieval of information. Scanning documents and digitizing them can help to visualize or share them effortlessly.

Take special care and protect each client’s information. Ensuring data security is of utmost importance. Staff members should coordinate with each other regarding access to information and accountability for performance.

Use the latest systems for better revenue management.

Achieving a higher DME revenue cycle is only possible when there is effective revenue management. Get rid of obsolete AR applications and bring the application with the updates and changes in the healthcare industry. Leverage the EMR (Electronic Medical Records) to

manage patient data, follow-ups, claims and reimbursements. It can help automate patient collections and simplify billing and coding.

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