When it comes to durable medical equipment (DME), there are many factors to consider. From medical necessity to coding, there are numerous rules and regulations to follow when it comes to billing. Fortunately, there are companies that specialize in DME billing.
DME billing is the process of submitting claims to insurance companies for equipment used for therapeutic purposes. Although Medicare covers the more basic forms of equipment, equipment that is used beyond a reasonable medical need may be paid for only by the patient. This is why it is important to make sure that the claims are billed correctly.
To ensure that DME billing is effective, providers should take the time to learn about its various requirements. A robust billing system will help optimize the billing process, keep track of denials, and monitor changes in industry guidelines.
One of the most important components of a robust billing system is prior authorization. Using prior-authorization technology will speed up the process of obtaining approvals. It can also integrate with an EMR. By keeping a close eye on the relevant data, you’ll be able to improve profitability and reduce risk.
Another must have component of a robust billing system is an auditing system. Insurance companies often conduct audits of DME claims to ensure that they are paying the right amount. Without the proper documentation, you could find your claim being slowed down or denied entirely. In such cases, your company will need to respond promptly.
Lastly, a robust billing system should also include a robust accounts receivables process. While it is not possible to know the exact details of each and every claim, it is necessary to make sure that it is properly logged and tracked. For example, if you have to send a bill for a home blood glucose monitor to a patient, you must ensure that you have the necessary paperwork in hand.
The correct billing process has a ripple effect throughout the organization. Having a robust system in place helps providers receive the highest reimbursement. Ultimately, a robust system will help you keep your clients happy and increase your profits.
A successful billing process will ensure that you are able to submit accurate and timely claims. With a solid billing solution in place, you’ll be able to get paid sooner and receive better reimbursements.
To learn more about the best DME billing solutions, contact Knack Global, a provider that has the expertise and resources to get the job done right. They offer a complete DME billing and processing service, allowing you to focus on other areas of your business.
If you are a DME provider, you’ll need to register with Medicare and Medicaid. You’ll need to do this in each state where you plan to sell your products and services. Failure to do so can impede your business’s operations and put you at financial risk. Also, if you are selling DME to the general public, you’ll need to be licensed in the state where you plan to do so.