How to Pick the Right DME Billing Partner

Do you Really need a DME Billing Partner?

Billing for Durable Medical Equipment, or DME billing as it is often referred to, is a complex process which is usually more stringent than other kinds of medical billing. The need for documentation is usually more elaborate in the case of DME billing. The codes and modifiers that are required to be used on the bill are also, most often, greater in number. Moreover, frequent changes in payor regulations require a constant upgrade of the coding standards. In short, it may be safely concluded that DME billing services constitute one of the most time consuming and tedious systems in the entire medical billing industry.

Faced with such typical complexities associated with DME billing, many providers often find it difficult to meet the rigorous demands of the job. It is a precarious territory where even the slightest slip can lead to an outright rejection of your claim for reimbursement. As such, DME providers frequently opt for professional assistance in the matter. In other words, they prefer outsourcing their DME billing requirements to dedicated and experienced billing service providers. The benefits are many, chief among them being improved collections, reduced denials and streamline, more efficient operations.

What to look for in your ideal DME billing Partner?

One of the most important factors that contribute to the overall ability and competence of a billing service provider is experience. So, when choosing a DME billing partner, it is always advisable to go with the older players in the market. Startups are best avoided, and those which have been around for just a few years, need to be examined closely. If you are able to find a company that has been in the medical billing business for more than 10 years, stick to it.

Speaking of experience, you should also ensure that the company you decide to partner with has plenty of hands-on experience in the DMEPOS billing process. A good billing partner will fully understand the complexities of the DME billing process and be fully equipped to handle every aspect of the entire revenue cycle for DME providers. This, of course, include having proficiency in obtaining prior authorization quickly, coding correctly and accurately, collecting and submitting all required paperwork, handling denials with unnecessary delays and following up with insurance companies to ensure quick payment.

One needs to bear in mind that DME companies invest a lot of time in coordination and communication with the physician’s office. In some cases, the prescribed DME requires prior authorization and multiple follow-ups. So, choose a billing partner who possesses thorough knowledge of coding and payer guidelines and can delegate resources for follow-ups that not just reduce the turnaround time but also improve the cash flow. Essentially it’s all about being able to efficiently handle and manage every aspect of the revenue cycle, beginning from order entry to achieving zero balance in account, and everything in between.



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