Any items that are necessary for supporting a need medically are referred to as durable medical equipment. It includes hospital beds, ambulatory aids, wheelchairs, compressors, and more. Most of the insurance companies term these as benefits under (durable medical equipment) DME, only when there is a physician says there is an absolute medical necessity for using these items.
One of the unique aspects can be although the item is described as (durable medical equipment) DME, some items fall under the (home medical equipment) HME category as it is usually a service under home medical equipment that they are used as. Items under (home medical equipment) HME cannot be one dimensional, rather it is multi-dimensional as the patients that require such (durable medical equipment) DME services and items to be home delivered.
Things to Know Under DME Billing
In billing for durable medical equipment, it is important to detail down that every requirement with safety are met in a home where the prescribed item can be installed or delivered. Some companies that offer DME billing insist that the recipients go through the instructions detailing the usage and operation and maintenance.
There are a lot of activities involving checking the eligibility of a patient under the insurance coverage for a particular item of (durable medical equipment) DME. Also, there are a lot of other activities in DME billing that includes, getting the prior authorization in place, creating and confirming the sales orders as well as following up with the prescribing physicians with the relevant documents.
Effective coordination is needed right from patient calls whenever reimbursements are challenged by the insurance carriers. If the purchase is not met, the items have to retrieve from the homes of the patients which can also be declared as a part of the activities under DME billing.
Things to Consider in HME Billing
A chunk of activities under (home medical equipment) HME activities involves hiring and training the related staffs with safety provisions for vehicles and the other associated maintenance processes are well adopted. Also, it has to be ensured that 24/7 services were made available for the patients. Licensure under the FDA is a critical requirement to be met.
A specialized team in HME billing helps in focusing on the inventory and staff crunches in house. Also, there will be critical support delivered with CPAP compliance which translates to better collections in the long run for an (home medical equipment) HME provider.
One of the biggest advantages that a (durable medical equipment) DME or a (home medical equipment) HME provider can avail with outsourcing is access to a pool of resources that help in improving business ROI in the best possible manner. As a reliable operational extension, they work to eliminate proven pain points in your practice management standards, offer streamlined support that accelerates reimbursements in the longer run.
To conclude, a quality HME billing/DME billing team that transpire your ROI, help you in eliminating proven pain points in your revenue cycle by delivering the specialized intervention. It helps a provider focus on core competencies like care management, logistics, and improve on their financial health in the best proportions.
Sunknowledge Services Inc. – an ISO 27001:2022 certified, American-owned & operated company, headquartered in New York City – is a leading global provider of Business and Knowledge Process Outsourcing services in the US healthcare domain.
