Durable medical equipment billing industry is undergoing perennial renovation, thanks to the ever-changing regulatory compliances. Staying current with the shifting DME billing landscape is a significant challenge, which is why outsourcing durable medical equipment billing services are the go-to thought for most companies. Shrinking collections, billing errors, cost of training new hires for billing functions, and suspended operations in the absence of staff are many concerns faced by medical equipment providers.
If neglected, all existing problems can compound leading to slow productivity and revenue. If you are troubled by these challenges, outsourcing DME billing services to Flatworld Solutions is the safest choice to rebound from adversity. We work round-the-clock to bring you higher reimbursements and better cash flow.
What is DME?
Durable Medical Equipment (DME) is a therapeutic equipment that is prescribed by licensed physicians to patients who suffer from certain medical condition or illness. Equipment used for convenience or beyond reasonable medical needs of a patient is not covered by DME billing. Nebulizers, ventilators, kidney machines, etc., are an excellent example of durable medical equipment. DME are mostly intended for therapeutic benefits for patients suffering from long-term medical conditions. It may or may not be beneficial to people without ailment. All DME is highly durable for an extended period of operation (mostly for home usage).
What is DME Code?
The pricing, data analysts and coding (PDAC) specialists like us use customized durable medical equipment coding system (DMECS). This system is a directory of all codes used in DME services. It is helpful for distributors and suppliers to efficiently keep track of the billed services so that claims can be fast-tracked. However, it is important to note that DMECS is not a substitute for HCPCS releases. An Example of DME equivalent of HCPCS code for CPAP is HCPCS code E0601.
The modifier for this code is -
RR - rental
KH - first-month rental, and Initial claim
KX - documentation to support medical necessity
What is DME Billing Service?
After coding the invoice, it is necessary to compile documents catalog and records for electronic claims submission. However, before submission, it is crucial to check if the documentation is complete and accurate. Missing documents and non-compliance are among many reasons for delay or denial of payment. A billing company like ours pay close attention to the quality of documentation to ensure clean claim as well as lower DSO and denials.
DME Billing Services We Offer
Lower reimbursements can be bad for revenue cycle management especially when the cost of durable medical equipment is inclined to be expensive. Unless we take radical steps in quality control the problems will continue to manifest themselves. At FWS, we check policy compliances to guarantee completeness and accuracy of claims to avoid attracting audit. We keenly look for discrepancies and rectify unresolved errors. We offer the following as part of DME medical billing services -
With a goal to eliminate fatal and non-fatal document errors, we appoint trained professionals to closely work with providers. Our billing professionals will patiently collaborate with your team to obtain information relevant for insurance companies. We meticulously collect and analyze the privacy-compliant data from your end. This data is securely held in our database for easy retrieval and error-free billing.
We send routine statements that are crisp and accurate by summarizing the practice and facility. We check statements for errors before dispatching the copy via email.
Payment discrepancies are hard to resolve without expert help and knowledge of carrier-specific claims guidelines. If the reimbursed value is lesser than your expectation our denial management service will come to your aid. If you are underpaid or denied payment altogether due to non-compliance we rectify the flaw and file appeal to ensure you are correctly reimbursed without being subjected to further ordeal.
Claims Filing Assistance
Claims filing is often overlooked as a straightforward process that needs nothing more than handling form fill outs. On the contrary, it is a crucial step that contributes to the speed of claims processing. We reorder invoices and claim documents as per the insurance carrier's preference because each carrier follows a unique standard while accepting documents from the claims initiator. After ensuring completeness of the digital and paper documents we file claims electronically in the format recommended by your insurer.
Custom Report Development
We generate custom reports on a monthly, weekly, or daily basis depending on your practice requirements. Our reports can shed light on DME services availed by your clients with descriptions as well as analysis of your practice's financial performance. With our reporting services, you can streamline the productivity on the go thanks to simple UI that lets you choose relevant filters. The reports can be generated based on custom parameters that facilitate quick retrieval.
Payment Posting and Auditing
Once we collect explanations and payments from your clients, every detail is reviewed in-depth to ensure correctness. After making sure the data is error-free and valid we update the values in our database for record-keeping. We also communicate the explanation of benefits (EOB) to you so that the reimbursed amount can be compared and reconciled with our records from your end.
Fee Schedule Update
We collaborate with insurance companies to set up and routinely update fee schedules. FWS's team negotiates fee schedules with insurance companies by considering the annual inflation and median cost of living. Additionally, we keep track of aging reports by frequent follow-ups. We stay in touch with insurance companies after submission to ensure a quick turnaround.
DME Billing Process We Follow
As a responsible DME medical billing company, we follow a unique step in the process execution which is straightforward and easy to validate. Here's how we carry out DME billing for our clients -
01. Sourcing Support Documents
Upon outsourcing DME billing services to FWS, we collect invoices and other important transaction records for analysis
02. Eligibility Check
We engage providers and insurers to ensure that your client is eligible for claims and its coverage benefits
03. Customized Billing and Patient Statements
We code the invoice and transaction records so that it is efficiently documented for easy retrieval and management. Our observations and analytics data are compiled into reports and timely statements
04. Electronic Claims Filing
After ensuring the accuracy and completeness of records we send the files and documents in the digital format sought-after by your insurance provider
05. Routine Follow-up on Claims
After filing claims, we follow up with the insurer to inquire about the status of claims submission. Frequent follow-up will lead to faster processing
06. Round the Clock Service Support
The payment released by insurers are captured and posted into your account for reconciliation. In the case of payment discrepancy, we provide denial management support
Why Choose FWS's DME Billing Services?
If done negligently, Billing functions can result in delayed payment or claim denials, dealing with which can be costly and resource-intensive. Most third-party DME billing companies just take care of filing claims without prudence and are primarily focused on increasing their own revenue. But we always go an extra mile in ensuring that the filing process is carried out with due diligence and completeness without risking payment loss. Here are more reasons why you should partner with us -
Certified Billing Company
We are a HIPAA compliant, as well as ISO certified company that is willing to take the risk and efforts to turn your claims into promising payments
We are an ISMS certified organization and take stringent measures (internal and external) to safeguard your data stored in our repository. Our cloud network is secure because it is protected by firewalls to prevent intrusion and misuse
High Accuracy and Quality Service
While billing your practice we ensure that no part of the service is overbilled or underbilled because faulty bills are prone to claims denial. We double check the files for accuracy and quality before submission
Save close to 50% in time by partnering with us because we offer service are tailored for your needs rather. In this way, you get nothing more in the form of unreasonable addons
Being equipped for evolving challenges is the best way to future-proof billing service. Our billing solutions are scalable offering immunity against unplanned change in policies and process
The major benefit of choosing our services is that you need not spend a fortune to avail our services. You can save close to 30% of the cost by choosing our affordable DME billing solution
You no longer need to wait until you hear from us. Get a quick response to make faster decisions. We appoint a dedicated professional who will work within your time zone to swiftly respond when you need our help
Experienced and Certified Coding & Billing Experts
We understand the importance of having the right people responsible for coding and billing functions. With 8+ years of experience in the advanced billing software, our coders and billers are certified professionals who are aware of the ICD-10, ICD-11, and DSM-5 coding conventions
Our advanced infrastructure is the powerhouse of innovation. Our motivated team, as well as customized billing tools and resources, are housed within our infrastructure. We develop faster and efficient solutions that will boost your revenue in no time
Secure Data Sharing
Share data with safer and easier when you partner with us because we use VPN and secure FTP that takes care of your valuable project files in transit. Being completely protected by world-class security we keep your valuable data immune from eavesdropping and unauthorized access
24/7 Remote Access to Financial Records
When you want access to all billing records on the go we offer a convenient way to let you stay on top of every record anytime, anywhere through the Internet
Salient Benefits of Outsourcing DME Billing to FWS
95% increase in clean-claim settlement
Jump in revenue by up to 30%
Error-free and Fast billing
Client Success Story
Provided High-quality DME Services to a California-based Client
The client wanted to partner with a professional service provider who could provide the services at a very competitive price and within a quick turnaround time Flatworld Solutions was a qualified partner that matched their budgetary needs and the project was executed as per the client's satisfaction.
Provided Accounts Receivable Management & Medical Billing Services to a US Client
The client approached Flatworld Solutions in the wake of problems they faced due to decline in collection, shoddy billing work by in-house team, and incomplete billing. We analyzed the challenge and swiftly provided billing solution. All that within the short deadline as the client was time-constrained.
I really appreciate you & your teams help in the coding that is being done. The keys to success with my team are rapid turnaround & complete coding of all diagnosis codes in the Health Risk Assessment. I've been extremely pleased that all diagnosis codes are captured, & the coding is done well within the time frame that is allotted.