How To Minimize Denials in HME Billing

Handling Denials in HME Billing

Denials are common in the realm of medical billing. Every day, a handful of claims submitted to insurance companies get denied on grounds of inaccuracy, incompleteness or a bit of both. When it comes to HME billing, the amount of denials often tends to be more than other kinds of healthcare billing. This is largely because HME billing is a complex affair, requiring an extra bit of attention and diligence without which it is prone to be overturned by the payer eventually.

This is common knowledge to all HME providers. This is why, true success with HME billing is seen in quarters that employ the best talents in billing and coding. However, this is a somewhat difficult proposition nowadays, especially amidst the current dearth of skilled labor in the market. With minimum wages rising in various states across the U.S., recruiting skilled billers has become more expensive than ever for most HME providers.

In the face of such challenges, HME billing processes are getting increasingly outsourced to dedicated, professional billing service providers. But is it really helping to improve the outcome, to increase collections and reduce denials? Let’s take a closer look.

A Critical Analysis of Outsourcing

The mention of outsourcing business processes often raises quite a few eyebrows. The opinions are mostly varied. There is a camp that fails to see any real merit in outsourcing. There is yet another coterie that is undecided. However, a large section sounds fully assured of the many benefits of having an external billing partner. The crux of the matter lies in choosing wisely, as billing service providers come in all shapes and sizes, and one must pick the best one to work with to ensure the most favorable results.

The main benefit of outsourcing a billing process to a billing agency is the degree of dedicated attention that the process receives from such an association. With such attention, errors are reduced, denials get slashed and more claims get passed than before. And given the highly competitive rates at which such outsourced assistance is usually available, healthcare providers can now get efficient billing without burning a hole in their pockets.

It also allows businesses to have instant access to fully trained and highly skilled revenue cycle management personnel, without having to sweat over scouring the market for such resources and then going through the whole rigmarole of recruiting and training them afterwards.