- October 30, 2021
- Posted by: Thomas Anderson
- Category: DME Billing
The Durable Medical Equipment market size in 2021 today is valued at more than USD 5.9 billion and is expected to expand at a compound annual growth rate (CAGR) of 6.0% over the forecast period. Witnessing a huge growth, the demand for the DME medical billing market today has mostly contributed for the factor like:
♣ Rising number of the aging population
♣ Huge jump in the number of people suffering from sleep apnea and respiratory illnesses,
♣ Accident especially due to sports injury etc.
However, with such huge growth the challenges in the DME billing process have become more complex than ever and so are its reimbursements. In fact, here are few common DME medical billing challenges:
⇒ Documentation errors – being an essential part of DME billing and coding, a seamless DME billing requires proper documentation. As insufficiency in records and incorrect information in documents prolongs the overall payment cycle and the overall betterment of the healthcare practice/ centers etc. In fact, at times suppliers are seen even holding the shipment of the supplies until documentation is complete and perfected.
⇒ DME coding errors – it is often difficult to keep a track of changing codes regularly, resulting in coding errors. The most common four coding errors are in fact:
♣ Incorrect HCPCS codes that drive a diagnostic related group (DRG)
♣ Mistake in the seventh character for trauma and fracture diagnosis codes
♣ Overlooking the use of guidance tools
♣ Insufficiently documenting devices, components, grafting materials etc.
⇒ Guideline issues – there are specific guidelines across payers which needed to be followed for seamless DME medical billing operation which if not considered results in denial. The most common payers denying claims are in fact:
♣ Unauthorized by Medicare/Medicaid/private health insurance plan
♣ Absence of the correct HCPCS, which represents level II codes assigned for DME gear and supplies
♣ Former permissible reimbursement level
With so many challenges it is very essential for healthcare practices today not only ensures a proper team with complete DME medical billing process knowledge but a team that has the experience and the right skill set to overcome billing challenges like Sunknowledge Services Inc.
Working in the DME billing industry for more than 12 years, Sunknowledge Services Inc today offer customized RCM solution helping many leading DMEs with a better billing operation and a faster ROI. Increasing their cash flow, boosting operational performance, heightening collections efficiency, and diminishing revenue leakage at a cost effective rate, we today are one of the leading RCM soluition with excellent industry references known for reducing the operational cost by 80%.