21st Century Cures Act and Impact on Medicare DME Reprocessing Claims: Challenges with DME Billing

If there were not enough challenges with DME supplies and services, healthcare providers need to be aware of the massive change that CMs has implemented impacting 36000 claims a day for a total of 24 weeks.

The 21-st century cures act is now responsible for conducting the adjustments to fee amounts for certain DME competitive bid items. During the six month tenure, providers were paid less for their services while are paid and reimbursed slightly more based on the new fee schedule amounts. How fast your claims are reprocessed will depend on which jurisdiction you fall under.

While it sound great to be paid more money for the services that you render, there are several things that a DME provider needs to be aware of, to manage any issues, challenges during the transition period. You will need the intervention of a specialized partner that works as an extension to your operations.

“In Excellence We Trust” the “full proof” Sunknowledge DME billing action plan

Through process simplification and automation, as a powerful medical billing and collections company, Sunknowledge services Inc. provides a visibility to our clients with critical business KPIs. We help in improving your business profitability, streamline your operations with integrated solutions. The best part, we are ready to work as your reliable operational extension with guaranteed account management/reporting standards.

Now, get paid more and faster with our specialized support in DME billing. We are your one -stop destination for end to end practice management/medical billing support. At present, Sunknowledge is working with over 100 clients, providing them complete assistance.

We are versatile and proficient across all cloud based business management software in billing and it is the reason for our 100% client satisfaction track record/zero attrition over the last 10 years. On an a la carte basis, we offer the following solutions in DME billing:

  • Eligibility Verification and authorization
  • Doctors office follow- up
  • Scheduling and payment posting
  • Accounts receivable services
  • Charge Posting
  • Denial Management
  • Patient collections follow up
  • Contact center services

Also the key facts that we consider to avoid any errors of omission and commission:

  • Review encounter (SOAP) notes and select appropriate CPT/HCPCS and ICD codes
  • Claims generation and review of edits
  • EDI claims submission through clearing house with TAT of 24 – 48 hours
  • Claims rejection review and re-submission
  • Payment and denial management
  • Accounts receivables analysis and follow-up
  • Quality check is conducted at all stages
  • HIPAA compliance (Complete Data and Document Security)

Sunknowledge: The Ultimate DME Billing Partner

With the lowest billing fee percentage in the industry, cyclical reporting standards, and dedicated account management support at no additional costs, Sunknowledge Services Inc. demystifies proven challenge areas in your DME billing mandates. We are a one stop partner if you are looking for someone who has demonstrated experience in handling DME claims with all major payers , Medicare and Medicaid, Commercial plans, Capitation, and Fee for service plans. At present, you can avail a full time DME biller from us at just $7 per hour on a dedicated model of engagement. We make sure of the following:

  • 80% instant reduction in current billing operations cost
  • Ensure over 90% collections (even from ageing A/R)
  • Guaranteed 100% PA submission on the same day
  • We do prior authorization services at just $7/hr with 99% accuracy
  • Excellent references from industry peers
  • Shrinking the accounts receivable bucket by 30% within 1 month
  • No write offs/ adjustments without client approval
  • Free telemedicine platform for improved patient inflow alongside 100% RCM assistance.

We are equipped to handle complex contracts/claims, experienced working with various claims, and billing systems. In our DME billing efforts, we ensure claims processing standards of 98% in a turnaround time of 5 to 10 days. With a special focus on rejection/denial management, we provide our specialized intervention for an efficient medical billing and coding process. For a proven process performance and great upside potential, get in touch with our experts to know more about our functional best practices in DME billing. We are just a call away!



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