“Stop facing the same DME billing issues, and make a change to better your financial performance”
Many patients with long-term medical ailments face difficulty in their day-to-day activities. Durable Medical Equipment (DME) serves such patients by providing therapeutic benefits. It helps improve the daily function of patients, offering them a better way to live.
DME is issued to patients only under a prescription and includes ventilators, wheelchairs, nebulizers, prosthetic devices, and many more. Equipment is essential in the healing journey of the patient, and it is not eligible for use without being suggested. As the usage of DME is regulated, the effect of this is borne by healthcare providers. It raises the medical billing complexities, becoming a roadblock to achieving adequate revenue.
As a result, healthcare providers choose DME billing services to prevent the medical billing hassle. The outcome is not limited to that; they experience better and more efficient revenue cycles as well. Medical billing services handle all those aspects that hamper the growth of the practice and make sufficient reimbursement possible.
This blog highlights the issues in DME billing and how a healthcare practice can tackle them. First, we will explore the concept of complexity and then move on to the solutions to counter the same. By the end of this blog, you will be able to improve your medical billing process and generate enough revenue.
DME Billing Complexities that Hamper Your Growth
Mitigating the DME complexities can be stressful, but knowing the core issues behind them can help bring positive changes. This also aids the shift from your existing system to a more streamlined procedure, such as DME billing services.
Mistakes in Coding
One common cause of inadequate revenue is coding errors, which are usually due to improper procedures. The DME branch faces this issue too, where coding mistakes become the reason for reimbursement leakage. The errors might be incorrect usage of modifiers or the allocation of the wrong CPT codes. Not just this, there might be under or over-coding that can lead the practice into legal trouble. Missing documentation also contributes to coding errors.
All these reasons can hamper the financial posture of healthcare practices, and healthcare providers can suffer losses. To prevent this, they must take steps to avoid such problems and improve their medical billing process.
Medical billing services are experts at managing coding with accuracy so that healthcare practices don't fall behind. They counter DME coding errors such as:
- Wrong HCPCS codes
- Inaccurate codes for trauma and fracture diagnosis
- Improper identification of respiratory failure
- Irregular recording of all components, devices, and grafting material properly
Incomplete Documentation
When patients visit, the first step is registration, and from that moment on every detail regarding the treatment is documented. This raises the need to maintain countless numbers of documents every day. This multitude of documents is hard to handle, and mistakes are bound to happen. There is also a wide scope for missing information. All these issues occur due to manual errors, and they further affect the entire medical billing process.
Proper data recording is crucial to a smooth medical billing process and a positive outcome. However, it is up to healthcare providers; the methods they choose to complete medical billing has a direct impact on the overall accuracy.
Performing DME billing themselves can be the cause of such mistakes. However, if they outsource to HME billing services, these issues will be solved, reduce time, and maximize their revenue at the same time.
Restricting Regulations
The frequent regulatory changes are a constant challenge on the road to perfecting the medical billing process that generates sufficient reimbursement. However, these ever-evolving changes must not be neglected. They play an important role in protecting patient information under HIPAA regulations and CMS guidelines.
Some other regulations for coding are meant to protect the interests of healthcare providers so that they receive value for their work. The rules and policies play a major role, and healthcare providers must make every effort to fulfill them all.
This protects them from getting into legal trouble as well and paves the way for a more systematic way of performing medical billing. As a result, healthcare providers must ensure that all regulatory measures are followed and up to date.
Defective AR Management and Denials
Defective AR management is a considerable challenge in DME billing, as it is something that controls denials. Failure to recover accounts receivable is due to faulty AR management, and this results in financial deprivation. Proper AR management calls for proper tracking, billing, and collection of revenue, which if handled effectively, can lead to adequate profits.
This drawback occurs because healthcare providers resort to older methods and fall behind in adopting newer ones. It becomes extremely vital to upgrade outdated ways to survive in the constantly changing healthcare landscape.
Healthcare providers must follow an appropriate AR management system to ensure that the financial health of the practice doesn’t suffer.
Inadequate Patient Coverage
This is something that can be easily brushed under the rug but is not beneficial for the DME providers. The problem arises when the insurance coverage doesn't allow a prescription for DME. If healthcare providers allocate DME without checking the insurance coverage, it can result in a revenue loss.
That is why verification of insurance is important to check for insurance coverage and whether the patient is eligible according to the insurance policy or not.
The repercussion of not following this step can be the denial of claims by the insurance company. Some patients need DME for their treatment, but the insurance company that covers their ailment may not include DME in it. To prevent this situation, healthcare providers must be proactive and thoroughly check the insurance coverage before making a prescription.
Lack of Denial Management
Denial management can be termed a core function in medical billing. It protects a significant amount of revenue with strategic handling and reclaiming. That is why ignoring denials is not a good idea for any healthcare practice.
This way, denials can keep piling up, making it hard to manage them and losing potential revenue along with it. There is a need for efficient denial management to successfully execute the medical billing process.
DME and HME billing services identify the root cause of denials and carefully manage to make appropriate changes to recover revenue. They follow a process of rectification and reconciliation to reclaim the lost revenue through a mere correction of claims and resubmission.
DME Billing Services to Maximize Revenue and Improve Bottom Line
Durable medical equipment billing is a complex task, and healthcare providers are on the lookout for better ways to improve. Medical billing services serve their purpose and offer them billing solutions free of any hassle. The results are also convincing, as outsourcing proves to be beneficial in terms of efficiency and profits.
When a DME provider opts for outsourcing, he/she gets the following benefits:
- Expert handling of medical billing
- Error-free coding and billing
- Proper documentation and verification
- Denial and AR management
- Streamlined revenue cycle
- Adequate reimbursement
All in all, with medical billing services, healthcare providers can shift their burden and keep their focus on offering quality services to patients.
Why Unify Healthcare Services
Unify Healthcare Services is an expert at DME billing services and provides top-notch physician billing services. Your requirement for a medical billing specialist ends here, as we offer medical billing solutions for your unique needs. Our expert coders and billers are well-versed in DME medical billing and ensure adequate revenue.
Experience a boost in your bottom line and lead your practice to maximum revenue and efficient operational workflow with Unify Healthcare Services.
