How to Choose the Right DME Billing Company - #1
In order to be a successful durable medical equipment supplier, you must know what durable medical equipment is and how to choose a company to help you submit claims for reimbursement. So let's begin with defining durable medical equipment. According to the Centers for Medicare and Medicaid Services, durable medical equipment is: 1. Equipment that can withstand repeated use 2. Primarily and customarily used to serve a medical purpose 3. Generally not useful to a person in the absence of illness or injury 4. Appropriate for use in the home What exactly does that mean? Items such as wheelchairs (both power and manual), walkers, hospital beds, nebulizers, diabetic supplies, ostomy supplies and as mentioned earlier some medications and even enteral and parenteral nutrition are all considered to be durable medical equipment. Visit our website for a list of all items considered to be DME/HME. What makes DME so special? There are rules and guidelines that apply to billing insurance companies for DME/HME, including Medicare and Medicaid, which do not apply to other services or prescriptions. DME has the highest possibility of fraudulent billing than almost any other category of medical billing according to the National Insurance Crime Bureau. It is of the utmost importance that a supplier goes to the lengths necessary to educate him or herself of all of the rules, regulations and guidelines for billing claims. When dealing with medical equipment, there are many variables that must be taken into consideration to receive prompt reimbursement. Often the little things can be overlooked if the claims are not evaluated by durable medical equipment (DME) specialists. Unlike prescriptions, DME must have its own set of files that include the proper documentation to support the equipment. The paperwork can sometimes be overwhelming for an inexperienced DME manager. The paperwork, the medical necessity requirements and the inexperienced medical biller can cost a pharmacist thousands of dollars a year in lost revenue. Many times, claims are denied and the pharmacist does not have the experienced staff necessary to appeal or research the cause for denials and the monies become unrecoverable. To start our series, we have defined DME/HME, what it means, and what makes it so special. Now that we have laid the proper foundation, we can move on to discussing what to look for when choosing a DME billing company. In next week's article, we will discuss some key points to look for when choosing a DME billing company. Other topices for future weeks include: 1. Beware of "real - time processing" 2. Third party claims switching companies 3. Customer service driven companies 4. Continuing education and training classes For more information, please visit http://www.dme-claims.com. About Author Cindy Rushing is the Business Development Manager for Billing Management Services and an independent consultant for the healthcare industry. Cindy has almost 20 years of experience in healthcare coupled with a degree in Healthcare Administration. Disclaimer: Article submitters are solely responsible for the content of their articles. ArtiLib can't be held liable for the contents of the articles. Report Abuse | Browse By Category |
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