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Our service covers everything from compiling necessary DME documentation to claims follow-up and A/R management. We are home to certified professional coders (CPC) and billers (CPB) who bring the required expertise needed to ensure faster payments, fewer errors, fewer claims denials, and reduced risk of compliance issues. We have a proven track record of simplifying durable medical equipment billing services for our clients. Here’s how we do it:
- Integrate electronic billing software with digital systems such as Electronic Data Interchange (EDI), Electronic Health Records (EHR), and Electronic Medical Records (EMR) to expedite and enforce accuracy in electronic claims processing for DME billing.
- Implement standardized procedures for accurately recording patient information, DME orders, DME item descriptions, medical necessity, and physician orders.
- Submit documentation demonstrating the medical necessity of the equipment to fulfill any pre-authorization needs.
- Ensure 100% code specificity and accuracy with accurate DME billing codes (HCPCS (E0100-E8002 code range), CPT, DMEPOS, modifiers, diagnosis, place of service codes, and NPI codes).
- Align DME billing procedures with fee schedules and payment guidelines of payers such as Medicare, Medicaid, Private Insurance Companies (Aetna, Cigna, Humana), Managed Care Organizations (MCOs), Veterans Affairs (VA), Tricare, etc.
- Maintain specific billing workflow for equipment and devices like mobility aids, oxygen equipment, hospital beds, prosthetics & orthotics, dialysis equipment, prosthetic limbs, Continuous Positive Airway Pressure (CPAP), nebulizers, diabetic testing supplies, and more.
- Adhere to regulatory guidelines while handling various aspects of DME billing models, including coverage criteria, Certificate of Medical Necessity (CMN), Proof of Delivery (POD), and rent-to-purchase agreements.
- Examine Explanation of Benefits (EOB) details to identify any instances of claims rejections and support the appeals process accordingly.
- Generate patient liability towards DME costs such as deductibles, copayments, and coinsurance amounts.
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