Sun Knowledge: Your DME billing and Practice Management Destination

Sun Knowledge provides end to end DME/HME billing services with excellent references. With our proven best practices, we analyze and help you derive at a potential of securing maximum reimbursements from your DME claims.

We provide you with a streamlined practice management experience, with best in class processes to manage your eligibility verification and authorization process. We will reduce your overall billing costs by 70% and guarantee a collection of over 97%. In fact, we are the only healthcare revenue cycle management that has a promising presence with both payers and providers in our claims adjudication expertise.

Provide the best practice Management standards

We combine robust processes and expert team of medical billers, coders that drive your DME billing to effective reimbursements. At present, we are handling more than 100 accounts in the DME space. Speak to our clients and get to know how we have been instrumental in eliminating their pain areas. Our biggest value proposition: a seamless business transition experience both on business and operational aspects.

For effective business transition, we will give you the right processes, plan of action and a zero installation set up. You can avail a DME biller from us at just $8 per hour and that too at a full time engagement. Our excellent accounts receivable recovery practices will only better your denial management aspects.

The Sun Knowledge DME prior authorization process

Sun Knowledge will provide you with an extensive prior authorization assistance that will cover:

Gathering of information:

• Patient information: Name, DOB, Insurance
• Ordering provider’s information: Name, NPI, TaxID, Address, Phone#
• Check whether ordering physician is PECOS certified
• Place of Service
• Service codes
• Diagnosis codes
• Units for each service code

Contact the payer

• Determine the process for prior authorization request submission, i.e. portal, fax, phone etc.
• Contact for UM/Prior Authorization department
• Fax to send medical notes (if required)
• Expected turn-around time
• Limitations/exceptions (if any)
• Check to determine whether patient is eligible based on payer requirements for Prior Authorization
• Initiate prior authorization request as per payers’ guidelines / protocols
• Follow-up with payer via outbound calls, portal etc. to check authorization status
• Follow-up with ordering physicians’ offices for medical notes, therapy charts, other documents etc. (if required)
• Provide additional documents/information if requested by the payer
• Update Authorization outcome in the PM/billing system. The information will include:
• Authorization
• Date range
• Units

Get in touch with our experts now for knowing how we demystify your DME billing challenges by laying down the right checks and balances. Ensure better collections and reduce your billing costs with none other than Sun Knowledge!



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