Due to stringent CMS and private insurance compliance requirements, as well as continuously changing coding standards like HCPCS Level II, DME billing services are intrinsically complicated. Prosthetics, physical therapy, geriatrics, orthotics, and long-term care for persons with disabilities are among the specialties with which they also overlap. By maintaining high clean claim rates, guaranteeing revenue integrity, and expediting the claims process, Medsurebilling’s skilled staff makes this complexity easier to understand. We provide precise, effective DME billing that helps you get the most out of your reimbursements thanks to our tried-and-true methods and focused attention to medical billing and revenue cycle management.
Due to its particular coding requirements, durable medical equipment (DME) invoicing is very different from regular medical claims. Every item needs a specific HCPCS (Healthcare Common Procedure Coding System) code, from respiration equipment to walking aids. When handled internally, this intricacy frequently results in billing problems or claim denials. Whether it’s Medicare Part B, Medicaid, or commercial insurance, our committed DME billing specialists at Medsurebilling are knowledgeable about these codes and the payer-specific regulations that apply to them. Our experience speeds up cash flow and lowers rejections, so your practice may get paid more quickly and consistently.
Revenue cycle management (RCM) and DME billing services are made to increase your revenue.
Intricate requirements beyond standard CPT/HCPCS coding must be managed by DME billing services. This involves following payer-specific documentation guidelines, using modifiers (such as NU, RR, and KX) appropriately, and adhering to local coverage determinations (LCDs). To guarantee correct reimbursement, each DME claim has a unique set of compliance checkpoints that must be closely adhered to.
For accurate invoicing, customized equipment—like intricate rehabilitation wheelchairs or specially made orthotic devices—needs thorough documentation. Clinical notes, a Certificate of Medical Necessity (CMN), and manufacturer invoices are usually included in this.
When filing claims for repairs or replacements, it is essential to keep track of the equipment’s warranty status. The manufacturer, not the payer, is in charge of servicing an item while it is still covered under warranty. Real-time inventory and warranty tracking is crucial because providers can only bill payers after the warranty has expired.
With qualified billers and coders (such as CPCs and CPBs) on staff who are knowledgeable about the unique requirements of DME and HME billing, Medsurebilling is a full-service medical billing company. Our cutting-edge medical billing strategy incorporates proprietary software that interfaces with your EHR/EMR, automatically updates payer policy changes, and guarantees that all claims adhere to DMEPOS Quality Standards. Our specialty is providing DME providers with end-to-end RCM solutions that guarantee efficiency and compliance from patient intake to payment posting.
You may choose how much or how little of your DME revenue cycle to outsource with our flexible RCM services. We grow with you, whether you require assistance with payer credentialing, eligibility verification, billing, or AR management. In addition, our team offers payer contract reviews, authorization management, compliance audits, and assistance with patient billing. You get more than just a billing company when you work with Medsurebilling; you also get a strategic partner who is concerned with your compliance and profitability.
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