- January 30, 2023
- Posted by: David Smith
- Category: DME Billing
Understanding the impediments to increasing DME billing collections
Billing for DME (Durable Medical Equipment) items can turn into a complex affair without an organized approach. Compared to other kinds of medical billing, DME billing requires an extra bit of attention and effort. By a rule of thumb, all DME items, in order to be reimbursed by an insurance plan, need to carry proof of medical necessity, require accurate coding depending on whether the equipment is purchased or rented, and must be pre-authorized.
Maintaining an efficient DME billing process, therefore, requires a meticulous approach to the whole process. Collecting and submitting every piece of supporting document that is required to accompany the claim, using the correct HCPCS codes and modifiers to accurately describe the item being billed, and securing the requisite prior authorization well in advance are just some of the things to look out for. It is important to realize that even the slightest slip in any of these steps can lead to a claim getting denied or rejected. And this can take a toll on the collection.
Boosting collections without increasing operational expenses
While the obvious way to improve the DME billing process, and thereby increase collections, is to employ skilled billers and coders, this may not always be the best option. This is because experienced DME billing personnel can be both hard to find and expensive to hire. This is why a rapidly growing number of DME providers across the country are choosing to outsource their billing operations to specialized, third-party agencies.
Strategic offshore outsourcing of a business process such as billing & collections, lets providers take advantage of the quick availability of trained resources ready to immediate engagement, as well as the low cost of labor in foreign markets. In such an arrangement, providers are usually required to pay for actual hours of work done, based on a pre-determined fixed hourly rate. With the absence of all other forms of cost which are normally associated with a conventional, in-house setting, providers can enjoy big savings in overall operational and administrative expenses. What’s more, professional intervention also helps streamline existing process flows, improve efficiency, reduce errors and in the end, increase collections.