Practice Management and Revenue Cycle Management for DME Billing

DME Billing Services

Providing billing services for Durable Medical Equipment (DME), or Home Medical Equipment (HME) as they are sometimes called, can be a time-consuming and tedious affair. Among other things, it requires in-depth knowledge of reimbursement guidelines of Medicare, Medicaid and Commercial Plans, and their caveat. DME billing also requires a constant adherence to quality and staying abreast of all the changes happening in reimbursement regulations and coding & documentation requirements.

Sunknowledge Services Inc. has a highly capable team for DME billing services, who can make life easier for you from the very first day. With Sunknowledge by your side, you can leave all your DME billing worries to expert care. Outsourcing your billing requirements to us will allow you and your staff to concentrate on marketing, growing and running business operations, rather than managing a billing and collections department.

We have the highest productivity in the whole DME RCM world

DME – Productivity Estimation Productivity (daily)
Eligibility Verification – online 137 Patients
Eligibility Verification – online (with same/similar check) 107 Patients
Eligibility Verification – calling (with same/similar check) 48 Patients
Eligibility Verification – calling (with same/similar check) BCBS 20 to 25 patients
Prior Authorization 24 New Request
Prior Authorization (with dr.’s office follow/up) / Re-authorization 19.2 New Request
Dr.’s office follow-up 32 – 48 Accounts
Order entry (patient, provider, insurance, item etc.) 60 Patients
Order Confirmation 80 – 85 Orders
Rejection management 100 – 150 claims
Payment Posting – auto (without audit) 800+ lines
Payment Posting – auto (with audit) 500 lines
Payment Posting – manual 180 – 220 lines
Accounts Receivables follow-up 50 – 55 Claims
Accounts Receivables & Denial Management 40 – 45 Claims
CPAP Compliance (with patient counseling calls) 30 – 32 Calls
Patient collections 45 – 80 Contacts
Re-supply order calls (to patient to confirm requirement) 60 – 80 Contacts
Hold (eligibility, authorization, insurance change, manual hold etc.) 45 – 50 Accounts

Note: This takes into consideration time taken while working on Brightree

DME BillingThe Sunknowledge Advantage on DME Billing Services

Our experience shows that the process for DMEPOS billing can be cumbersome due to its inherent nature, viz. the order getting generated from a physician’s office. This increases complications and the turn-around time as dependencies increase. Prosthetics & Orthotics, DME companies need to devote much time coordinating and communicating with the ordering physician’s office for a valid Rx, medical/therapy notes, etc. Equipment that requires prior authorization also involve innumerable follow-up calls. This is managed effectively by us through our methodical and streamlined process that tracks each request in detail ensuring timely follow-up. Payer guidelines are specific to diagnosis and a thorough knowledge of this result in drastically reducing denials. Our diligent physician and payer follow-up activities also help reduce turn-around time in DME billing and improve cash flow. The process starts with entry of orders and ends when the account has zero balance. This includes conducting eligibility checks, obtaining authorization, creating sales orders, scheduling delivery, submitting claims, managing rejections and denials, and proactively following-up AR.


  • Follow-up on incomplete prescription with physician’s office
  • Follow-up for document collection (diabetic verification forms, LMN, CMN etc.)
  • Error free patient entry
  • Error free sales order creation
  • 100% HIPAA compliance
  • Real time transaction audits
  • Primary and secondary insurance verification
  • Insurance verification for rental items
  • Obtaining authorizations & extending authorization
  • Open order audit and clean-up
  •  CPAP user compliance tracking and counseling calls to non-compliant patients
  • Claims submission within 48 hours of receiving proof of delivery
  • Rejection follow-up within 24 hours
  • Tracking and follow-up of partial or incorrect payments
  • Denial management based on detailed analysis
  • Methodical and proactive AR follow-up
  • Timely payment posting to reflect accurate AR
  • Customized reporting

we are expertise in

Sunknowledge billing executives have experience in working on several industry standard practice management and billing software:
  • Brightree
  • Kareo
  • Emdeon / Capario One
  • Fastrack
  • CPR+ HME
  • DME Works
  • Team DME
  • SOS
  • Meditech
  • Alpha Collector
  • OPIE
  • Futura
  • PrimeRx

Get started today!

We welcome you to explore our widely acclaimed range of solutions crafted especially for healthcare service providers just like you. We will be glad to offer you our powerful yet cost-effective DME billing services to help you take your business to the next level of success.

To find out more about how we can help you, simply fill out the form below and send it to us. Whether you are looking for more information or wish to receive a free, no-obligation consultation on DME billing, we are waiting to hear from you.

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