Handling DME Billing Complexities with Economy

The Correct Approach to DME Billing

DME billing is often a considered a more complex affair than other kinds of medical billing. This is mainly because DME (Durable Medical Equipment) items and supplies are not always purchased, but often procured on a rental basis. This fact alone makes DME billing somewhat different from conventional medical billing. It also requires meticulous coding that clearly mentions for which specific limb a particular supply is intended for. Coding accuracy is of utmost importance as it is often seen that slips in coding leading to claims getting denied or overturned.

Another important aspect of DME billing is establishing the medical necessity of the prescribed device or treatment. This should originate from the physician’s office and is a crucial element for ensuring that a claim for reimbursement will be entertained by the payer afterwards.

This and other aspects of the billing process, make DME billing a particularly demanding task, requiring specialized skill and the biller’s undivided attention. However, the reality is often far from it. Skilled billers are usually hard to find, and costly to retain. While a DME provider can employ such billers and coders, he should also be prepared to handle increased operational cost, because good billers don’t come cheap.

Alternative Ways to Improve Billing Efficiency Economically

In the face of such challenges, a growing number of DME providers are choosing to outsource their DME billing tasks to specialized, external billing service providers. One of the biggest advantages of such a strategy is that it lets providers get instant access to a ready pool of skilled DME billers without having to go through the conventional rigmarole of finding the right personnel, hiring them, arranging for the overhead, providing all the statutory employee benefits and ensuring all the other aspects of maintaining a regular in-house staff.

An added benefit comes from the highly competitive rates at which such external billers are available for work. Most of them are available to start working at a flat, all-inclusive hourly rate. In some cases, the cost could be a pre-agreed fixed percentage of the total collections realized. Both ways, providers stand to gain substantially by hiring external billing staff as it not only helps reduce operational cost and administrative hassles, but also improves overall efficiency of the billing process by increasing the collection rate and bringing down denials and other impediments to revenue generation.