dme medical billing

Common hurdles in DME billing

Medical billing is a highly specialized field of operation, requiring both precise expertise and exact knowledge in equal measures. DME billing is no different in this regard. Knowing how to use the right codes, which documents to attach with the main claim as proof of necessity, and about all the payer norms to ensure that the submitted claim is not overturned, ensure success in Durable Medical Equipment billing.

In reality, however, much of the above resides in the realm of wishful thinking. Unless a provider is fortunate enough to have his billing desk populated with expert and skilled personnel, slips in Durable Medical Equipment billing can become a common sight. One of the most frequent problems encountered in billing is failing to distinguish between DME that is purchased and DME that is rented. DME billing also requires a high degree of precision, and billers must be as detailed and accurate as possible when using HCPCS codes.

A major reason why DME claims often get denied is failing to provide all the requisite supporting documents as demanded by the patient’s Health Plan. Failing to obtain prior authorization for a prescribed device is also another reason why many claims get rejected afterwards and patients are left to foot the bill by themselves.

Aiming for better management of the DME billing process

In a bid to reduce errors and improve the collection rate, a large number of DME providers have already enlisted dedicated assistance from specialized external billing service providers. Through strategic offshore outsourcing of their billing tasks, DME providers are not only enjoying a more efficient operation of their revenue generation process, but also finding more time for themselves to devote to patient care than spending over tedious billing tasks.

One of the strongest benefits of outsourcing DME billing is the amount of savings that providers can make in their operational and administrative expenses. In a typical outsourced scenario, billers and coders are available to work at a very competitive hourly rate. This, along with the absence of associated expenses like hiring office space, paying employee benefits and other overhead expenses, makes up for fantastic savings on the provider’s part. This reason alone makes outsourcing such an attractive option for DME providers everywhere.


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