Tips To Overcome The Changing Orthotics Billing Rules and Regulation

According to a report by the American Orthotics and Prosthetics Association for the Durable Medical Equipment, Orthotics, Prosthetics, and Supplies (DMEPOS); a significant change to the requirement for physician orders was announced by the Centers for Medicare and Medicaid Services (CMS) early this year. Eliminating the need for an initial/dispensing order for Medicare DMEPOS services, the change is effective for claims from the starting of the year 2020.

In fact, the report also stated that from January 2020, in the billing process for DMEPOS a “standard written order” (SWO) will only require for Medicare claims. While only one type of order is needed for DMEPOS claims, this effort by CMS is mainly to help reduce the supplier and provider burden.

While the standard written order” (SWO) must be received before claim submission itself, it must necessarily include exactly the same elements as the traditional “detailed written order” requirements for compliant DMEPOS claims. While the new SWO include:

• Beneficiary name or Medicare Beneficiary Identifier (MBI)
• Date of Order
• General description of the item
• Can be either a general description, a HCPCS code, a HCPCS code narrative, or a brand name/model number
• All separately billable features, additions, options, or accessories must be listed separately on the SWO
• All separately billable supplies must be listed separately on the SWO
• Quantity to be dispensed, if applicable
• Treating/Ordering practitioner’s name or NPI
• Treating/Ordering practitioner’s signature

As the rules and regulation of the medical billing world are ever changing like this, it becomes extremely complicated for many healthcare provider’s billers and coders to keep a track of and often end up missing out on new regulation; resulting in billing errors in the HME, DME, orthotics etc billing process.

This is where outsourcing RCM organization can help. With experienced billers and coders, outsourcing organizations are not only regularly up to date but also have complete knowledge of the present industry mandates, hence reducing the chances of errors in the orthotics billing process.

Sunknowledge services Inc. offers dedicated support at 1.99% or $7 per hour providing seamless orthotics billing process along with efficient revenue generation.

Offering the first 30 days free, the outsourcing organizations also have added advantage of 99.9% accuracy rate, robust reporting while 75% reduction in the operational cost too. With no binding contract and excellent client’s references, these operational extensions with their superior pool of resources have the ability to transform your cash flow completely.



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