- June 20, 2022
- Posted by: Steve Smith
- Category: HME Billing
Understanding the Demands of HME Billing
Billing for medical services and products, with a view of collecting payment from the patient’s insurance plan, is not a simple process. It requires meticulous attention to detail, speed and accuracy, and a thorough knowledge of payer norms and regulations. HME billing is no different. One can never be too careful when billing for HME (Home Medical Equipment) as even the slightest error or overlook can lead to a claim getting turned down by the insurance company.
It’s easy to understand why a skilled biller is often considered such a true asset for the billing department. The skills of the biller are directly linked to the overall collections of any health care provider. In fact, the success of an HME business depends heavily on having a robust team of billers and coders because the entire HME billing cycle is made up of a number of different components, each of which needs to be completed with great care and accuracy in order to ensure the final payout. These include, but are not limited to, such key activities as verifying the status of the patient’s insurance plan, collecting all requisite details, obtaining prior authorization for the prescribed item, filling in all the necessary details in the claim form and adding all the requisite codes, and regularly following up with the insurance company to actuate the payout.
Saving cost (without cutting corners)
It’s a no brainer that recruiting, training and maintaining such a team of billing professionals is a costly affair for most HME businesses. If one were to combine their salaries, employee benefits, the cost of overhead and allied expenses, the overall profitability of an HME business can be at stake. This is all the more true with the rapidly growing rate of inflation that is blowing across the land.
In view of this scenario, a large number of HME providers are outsourcing their billing operations to more economical, offshore billing agencies. One of the immediate benefits of such a decision is a drastic drop in operational cost.
Another advantage is an amelioration of the entire revenue cycle. Denials have been noticed to go down, and collections improve when providers choose a skilled billing partner to work for them. It also leaves them with more time that they can spend in actual patient care or in generating fresh business for their practice.