How to Ensure a Foolproof DME Billing Process

Identifying Common Pitfalls in DME Billing

DME billing, done with a view to obtaining the maximum eligible reimbursement from the patient’s insurance plan, is not a simple affair. True, it has its fair share of complexities and all the usual challenges commonly encountered in medical billing in general. But more than that, it is fraught with myriad possibilities of failure. Even the smallest deviation from the accepted norm, or the slightest overlook, can lead to a tacit rejection of a claim.

So how does one ensure a better success rate in DME billing? Well, one may start by identifying the areas where most billers tend to slip, and then be extra alert while performing those tasks. In this context, one should start by looking at the coding part of the billing process. Faulty coding can be attributed, in a broad manner, to using the wrong codes, or under-coding, or over-coding. While the first problem can be more or less addressed by double-checking that the right HCPCS code has been used to describe the item, supply or service being billed, the remaining two problems on the list are of a more serious nature. Under-coding, for example, which essentially equates to missing out on billing for items that are bona fide billable, can easily lead to getting back less reimbursement than one is actually entitled to. What could be more unfortunate than this?

Measures to Reduce Errors

Employing the best billers and coders that one can find is surely a great way to build a powerful and efficient DME billing department. However, with the current shortage of skilled labor in the market and the accompanying rise in wages for healthcare back-office personnel, maintaining such a team is both an expensive and difficult proposition.

This is why a growing number of DME providers across the US are opting for specialized offshore assistance in their DME billing affairs. The financial benefits are clearly evident in such an arrangement. However, the list of benefits hardly stops there. Professional intervention, almost always, produces an ameliorative effect on the entire billing cycle. A greater degree of efficiency is noticed, along with a higher rate of collection, fewer denials and faster payments.

It is worth remembering that outsourcing key billing tasks to professional and dedicated billers/coders is a great way to reduce errors in the DME billing process. It is also one of the most cost-effective ways to build a truly efficient billing process. The chief reason for this is that these specialized, billing service providers employ highly streamlined processes and advanced methods to ensure that more claims gets passed in less time, thereby maximizing a provider’s collections. Simply put, strategic outsourcing is an option that no serious DME practice can afford to overlook in today’s world.