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|
|Eligibility Verification – online (with same/similar check)||107|
|Eligibility Verification – calling (with same/similar check)||48|
|Prior Authorization (with dr.’s office follow/up) / Re-authorization||19|
|Dr.’s office follow-up||32 – 48|
|Order entry (patient, provider, insurance, item etc.)||60 Orders|
|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|
|Accounts Receivables & Denial Management||40 – 45|
|CPAP Compliance (with patient counseling calls)||30 – 32 Conversions|
|Patient collections||45 – 80|
|Re-supply order calls (to patient to confirm requirement)||60 – 80|
|Hold (eligibility, authorization, insurance change, manual hold etc.)||45 – 50|
Note: This takes into consideration time taken while working on Brightree
The Sun Knowledge 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:
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.