Building A Sustainable DME Billing Process

If you deal in durable medical equipment (or DME in short), you are probably no stranger to the usual troubles that accompany billing for such equipment. DME billing is slightly different from say, billing for medication, or a surgical procedure. One of the distinct characteristics of DME is the cost involved. Generally speaking, durable medical equipment are usually a costly affair. They typically cost more than medication. This fact alone makes it all the more critical for Practices to get paid for the medical equipment they provide to their patients.

The reality, however, is a different one. One of the biggest impediments in DME billing is what is known as prior authorization. In other words, establishing the medical necessity of a piece of DME and obtaining the required authorization from the concerned Payer, can spell nightmare for many Providers. When it comes to DME, many a time, prior auth requests are turned down. This can lead to tedious follow-ups till the required authorization is secured, resulting in a waste of valuable time that could have been better spent on actual patient care.

In view of such frequent problems with DME billing, a large number of Practices opt for dedicated third-party DME billing services that help them reduce denials, increase collections, have a more efficient billing process and stay in better control of their entire revenue cycle. Some of the best ones among these billing service providers work on an hourly rate, or simply charge you a fixed, pre-agreed percentage of the total collections they are able to generate. The latter is a win-win situation where the billing company earns in direct proportion to the claims they are able to clear.

Another benefit of an outsourced billing service is the amount of savings it brings in operational costs, not to mention the instant reduction of all the usual hassles and demands of maintaining a separate billing staff. It also eliminates the need for spending on expensive billing software as third-party billers take care of such requirements and directly post the payment to the Provider’s system.

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