COMPLETE DISASTER MANAGEMENT APPROACH IN DME BILLING SERVICES

DME Billing Services

Unmatched versatility, complete proficiency in delivering actionable support in DME billing services, Sunknowledge is a one stop destination offering comprehensive RCM support at the best pricing standards in the market place.

On a dedicated model of engagement, we offer our services on a stand-alone as well as end to end basis which means you can pick & choose from our services or rather opt for an integrated approach. Our team has proficiency across all leading practice management/ billing systems used in the competitive landscape.

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How Corona Virus Aid, Relief and Economic Security CARES Act has an impact on DME Billing

As far as the CARES Act, CMS is going to continue the adjustments with fee schedule amounts and services being furnished in rural and non-contiguous biding areas with a 50/50 blend of adjusted and unadjusted rates for the remainder of 2020. As required CMS is going to provide higher rates on certain items and services in the DMEPOS segment.

CMS has also paused the national Medicare prior authorization for certain items and the billing team has to aware of this changes. A fair knowledge of working with adjustments and how the newer regulations can improve reimbursements for a DME supplier should be a top priority. It is both an opportunity to gain a competitive edge and also streamline your DME billing efforts.

Q: How is Signature on Orders going to work on DMEPOS items?

All items and services under the DMEPOS category can now be ordered via a verbal order except for Power Mobility Devices. A signature will be required prior to any submission of claims for payment with the order electronically signed.
Power mobility devices however signed written order prior to the delivery. The front office of a PWD supplier has to ensure cohesive standards with order entry/ confirmation, doctor’s office follow up, checking the eligibility and authorization mandates keeping in mind the changes.

Q: What is Accelerate/Advance payments?

It is an initiative taken by the federal government and the CMS to provide additional cash flow to healthcare providers and suppliers that are hit hard by COVID 19. It is a conditional partial payment program to providers as well as suppliers to address any disruptions in claims submission / processing subject to applicable fraud, waste and misuse.

As of 26th April 2020, CMS is introspecting all pending and new applications for the Accelerated payment program and has already suspended by Advance Payment Program with the direct payment made available from the HHS provider relief fund. Any supplier of DMEPOS items will have to re assess their DME billing efforts so that they can leverage maximum benefits with compliance and consistency.

We have the highest productivity in the whole DME RCM world

DME – Productivity EstimationProductivity (daily)
Eligibility Verification – online120 – 137 Patients
Eligibility Verification – online (with same/similar check)95 – 110 Patients
Eligibility Verification – calling (with same/similar check)40 – 45 Patients
Eligibility Verification – calling (with same/similar check) BCBS20 to 25 patients
Prior Authorization25 New Request
Prior Authorization (with dr.’s office follow/up) / Re-authorization20 – 22 New Request
Dr.’s office follow-up32 – 48 Accounts
Order entry (patient, provider, insurance, item etc.)55 – 60 Patients
Order Confirmation85 – 90 Orders
Rejection management125 – 150 claims
Payment Posting – auto (without audit)800+ lines
Payment Posting – auto (with audit)500+ lines
Payment Posting – manual180 – 220 lines
Accounts Receivables follow-up70 Claims
Accounts Receivables & Denial Management40 – 50 Claims
CPAP Compliance (with patient counseling calls)30 – 32 Calls
Patient collections55 – 60 Contacts
Re-supply order calls (to patient to confirm requirement)65 – 70 Contacts
Hold (eligibility, authorization, insurance change, manual hold etc.)45 – 50 Accounts

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

The Sunknowledge Advantage in DME Billing Services

A 97% first pass collection rate which is one of the highest in the industry due to our stringent pre-billing services (eligibility, prior DME Billing authorization, doctor’s office follow-up, order entry & confirmation), we eliminate any future issues with claims getting denied.  Sunknowledge is an expert when it comes to order processing services!

KEY HIGHLIGHTS OF OUR DME BILLING SERVICES

  • 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

Our Robust Redundancy Plan in DME Billing Services will Help You Manage

  • Shortage of staffs due to outbreak of any natural calamity
  • Lack of staffs due to high rates of employment
  • Resource migration for meeting project deadlines

Why Choose us As Your Reliable DME Billing Destination

  • EXCEPTIONAL PRODUCTIVITY STANDARDS
  • NO WRITE OFFS OR ADJUSTMENT ON CLAIMS WITHOUT YOUR CONSENT
  • CUSTOMIZED REPORTING MEETING YOUR SPECIFIC NEEDS
  • ONLY MEDICAL BILLING COMPANY EXCELLING IN BOTH PRE/POST DME BILLING
  • OUR RATE IS AS LOW AS $7/HR
  • 70% INSTANTREDUCTION IN OPERATIONAL COST
  • DEDICATED ACCOUNT MANAGER PROVIDING YOU END TO END SUPPORT
  • WORKING WITH 100’S OF DME CLIENTS ALL OVER USA AND CAN PROVIDE EXCELLENT REFERENCES
  • LIABILITY INSURANCE COVER OF $1/3 MILLION FROM GEICO/ HISCOX FOR ANY ERRORS OF OMISSION & COMMISSION
  • 100% HIPAA COMPLIANCE
  • NO BINDING CONTRACT WITH 30 DAYS EXIT CLAUSE

 

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Hedge your bets on us as we ensure unparalleled consistency in DME medical billing with our task specific pre/ post RCM activities! We help you improve your cash flow; eliminate process loopholes that make you lose money!

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