- June 14, 2022
- Posted by: Josh Knoll
- Category: HME Billing
The Tricky Side of HME Billing
HME (Home Medical Equipment) billing may appear as a straightforward matter but in reality, it is more prone to errors and omissions than other areas of health care. As any HME provider will testify, ensuring 100% collections from claims made for HME products is a very difficult thing to achieve. Even the slightest of slips can lead to claims getting turned down. While this is true for claims in all kinds of health care practices, it is seldom more acutely felt than in the HME business.
It is a no brainer that rejected or denied claims mean no reimbursement by insurance companies, and therefore, a drop in the provider’s overall collections. Of course, the patient will be paying whatever applicable out-of-pocket expenses are involved, as per the coverage of the patient’s health plan, but that is an entirely separate matter.
Missing out on one’s dues is an unfortunate situation. This is even sadder when such a loss occurs due to some mistake made by the person who put in the codes or the biller who drafted the final bill. Many a time, a claim gets rejected due to the lack of all the required supporting documents (such as the doctor’s prescription, the letter of necessity or the delivery receipt of the HME). These, and a general failure to follow up proactively on denials, make HME billing a devilishly tricky affair.
No More Hurt
In order to save the headache and lower the possibility of revenue loss, a lot of HME providers across the U.S. are choosing to outsource their billing affairs to professional, dedicated, third-party billing service providers. These agencies have a huge pool of ready resources – comprising trained and skilled billers, coders and other revenue cycle management professionals – to start working on your accounts. They work as a seamless extension of your current billing department and can do wonders in taking the load off, free up your time and get your collections back on track.
The best thing about such an arrangement, however, is the economy it brings with it. Outsourced agencies can work at a rate which is remarkably less than what it would have cost to hire a regular, in-house medical biller. And providers are required to pay only for the actual hours of work done. No paid holidays, no employee benefits, and no overhead expenses. It is easy to see why outsourcing your HME billing now can help stop your business getting hurt and lower overall cost, especially during these times of soaring prices and labor shortage.