If you don’t observe proper coding, paperwork claims filing, and communication barriers, the durable medical equipment (DME) billing process can be incredibly difficult. DME Billing reimbursements are contingent on these factors.
The rise in demand of Home Healthcare
The market for durable medical equipment (DME) is booming. Given the current situation, which includes an aging population and a massive rise in the number of people suffering from sleep apnea and respiratory disorders, the demand for home healthcare is expected to skyrocket in the coming years.
Along with the expected growth, there will undoubtedly be numerous challenges. The DME billing process, as well as reimbursements, has become more complicated than ever.
The DME medical Billing issues mentioned below are some of the most common ones:
Insufficient documentation
According to statistical estimates, $2.6 billion of the $3.2 billion in the Medicare Trust Fund has been denied due to incorrect or incomplete documentation. As these paper works are an integral part of the process therefore it is ideal to keep track of and submit patient-related information.
Carelessness or even a minor error will result in claim rejection, concluding a waste of time and resources. This can have a major effect on your revenue generation.
DME coding errors
The top coding problems faced by healthcare providers are primarily the inaccurate application of the seventh character for trauma and fracture diagnosis. This is according to the survey report released by the American Health Information Management Association (AHIMA).
Apart from this, it furthermore includes challenges like:
- Improper use of guidance instruments
- Misdiagnosing respiratory failure
- Insufficient documentation of equipment and grafting materials.
As a result, incorrect codes may be another major cause of claim denials, confusing the DME medical billing process.
Managing Claims
Claims management plays an extensive role in the DME billing process. Once you’ve submitted claims, you’ll need to verify with the insurer regularly to observe whether there are any inconsistencies or how many claims are going to settle so that you can schedule the next few months.
DME medical billing companies face additional obstacles, such as novice billers and coders, a complicated pre-authorization process, and a shortage of software.
Hence, to conclude, as a DME provider/billing business, you should be aware of and always prepared for changes in DME billing codes and procedures. As a result, given the complexities of the DME medical billing process, outsourcing would be the safest and most ideal option.
When you consider the benefits of DME billing outsourcing, you will note the following:
- Increased profits
- More operational power
- Extensive Customer service
- Patient data protection and HIPAA enforcement
- Keeping up with ever-changing guidelines
- Invest more time in patients
If you’re looking to outsource your DME Medical Billing operation, find the top outsourcing partner with extensive DME industry domain knowledge.
