- July 10, 2020
- Posted by: Thomas Anderson
- Category: DME Billing, DME Billing Services
Today in this competitive DME billing industry, denial is the common problem that every healthcare provider has to encounter. In fact, in the year 2016, $262 billion out of $3 trillion submitted in claims was denied in hospitals across the US.
Furthermore, according to the research done and issued by Change Healthcare, 2017:
• Approximately 9% of claims that are been submitted are originally denied
• Denials cost the average health system an estimated $4.9M per year.
• Hospitals usually spend close to $9 Billion in administrative costs to retrieve the denied revenue nationwide.
• Rework up to 3% or more of their net patient revenue due to denials may done by the Hospitals
However worry no more, though the denial in the DME billing is a common and inevitable problem if take care cautiously, the denial rates can be reduced. Besides here are the top three steps that can help you in lessening the impact of denials on your bottom line:
Ensure of proper claims submission – evaluating the data before the submission of claims is extremely essential, as it reduces the chances of errors and so the denial rate; which eventually helps the healthcare from losing out on revenue. Saving a significant amount in the administrative costs due to all the stringent checks and proper verification during claims submission also aids in saving billers from hours of reworking too.
Have complete process knowledge – for a seamless DME billing operation starting from the data that’s needed to be collected to identifying the recent industry mandates, billing regulations, a biller must have complete awareness. As it is also one of the ways that help in reducing the denial rate for your DME billing process.
Outsourcing your HME billing services – recognizing clinical areas or departments that appear to be struggling with certain processes, outsourcing organizations take special care in handling the DME billing process with the help of robust reporting, dedicated and experienced billers and certified coders etc; recognizing the process breakdowns, gaps in policy adherence etc. Outsourcing takes the complete billing responsibilities starting from data entry, authorization verification to claims management etc; it also reduces the burden of many healthcare practices and helping them focus on their core work of patient care.
As the operational extension has its experience billers and coders continuously working on flow-up along with stringent checking in every billing and coding process it results in limiting unnecessary billing errors, hence reducing the chances of denial.
In fact, today with the rising competitive market there are many operational extensions that not only assist in reducing your DME denial rate with its stringent checks but also reduce your operational cost by 75%. Insuring a 99.9% accuracy rate in the billing and coding process, there are RCM organizations offering robust reporting, no cost dedicated account managers, and Highest Productivity metrics in the market along with a service charge as low as $7 per hour. Having a complete understanding of how to accurately analyze account history, ensure a timely turnaround to recover, appeal denied claims and close out A/R, these RCM organizations also offer no binding contracts for its clients.