- February 18, 2019
- Posted by: Thomas Anderson
- Category: Uncategorized
As a dynamic medical billing company, Sun Knowledge is working with leading payers and providers with great recognition. We are a quality centered revenue cycle management organization that has been providing cutting edge services in practice management/ denial management to leading specialties across the country. The experience that Sun Knowledge has in the DME billing space is quite a success story for you to assess especially if you are looking out for one!
♦ We have the references, the best knowledge when it comes to understanding your DME billing efforts for better reimbursements.
♦ Presently, we are working with over 100 clients only in DME space. At any time, you cans speak to the industry peers that are working with us anytime to know how clinical our performance has been.
♦ A combination of state of the art processes, expert resources will better your practice management and revenue cycle management priorities.
♦ We ensure a billing cost reduction of 70% and a collection of 97% with our disciplined understanding of claims adjudication mandates of the DME billing industry.
Partner with Sun Knowledge if you want to ride as a practice amidst the apprehensive mindset of the insurance marketplace with present administration to end ACA subsidy payments. There will be more impact given to practice management efforts to determine a better recognition of your medical claims. Payers will be circumspect as there is a fear that the ACA marketplaces will have fewer insurers.
Sun Knowledge has been working as an end to end revenue cycle management company that is proficient in all the aspects of DME billing with our excellent practice management standards. We will conduct the following
1. Gather the following:
♦ Patient information: Name, DOB, Insurance
♦ Ordering provider’s information: Name, NPI, TaxID, Address, Phone#
♦ Check whether ordering physician is PECOS certified
♦ Place of Service
♦ Service codes
♦ Diagnosis codes
♦ Units for each service code
2. Contact payer to gather the following:
♦ Determine the process for prior authorization request submission, i.e. portal, fax, phone etc.
♦ Contact# for UM/Prior Authorization department
♦ Fax to send medical notes (if required)
♦ Expected turn-around time
♦ Limitations/exceptions (if any)
3. Check to determine whether patient is eligible based on payer requirements for Prior Authorization
4. Initiate prior authorization request as per payers’ guidelines / protocols
5. Follow-up with payer via outbound calls, portal etc. to check authorization status
6. Follow-up with ordering physicians’ offices for medical notes, therapy charts, other documents etc. (if required)
7. Provide additional documents/information if requested by the payer
8. Update Authorization outcome in the PM/billing system. The information will include:
♦ Date range
All our efforts in prior authorization better your chances of ROI with a neat practice management process that leads to better rejection handle. Sun Knowledge is a champion DME billing company with proven expertise in AR recovery, denial management.