Durable Medical Equipment billing or DME billing is one of the most time-consuming and tedious processes in the healthcare industry due to constantly changing payor policies, regulations, and compliance requirements. To succeed in this ever-changing industry, it is critical to have an in-depth understanding of the latest regulations, DME billing processes, DME coding, and billing requirements. Even the slightest mistake in the process of DME billing can lead to claim rejections or denials, resulting in huge losses for the healthcare provider.
Here’s everything you must know about DME billing to reduce claim denials and ensure adequate payment for your services.
What is DME?
DME refers to the reusable medical equipment prescribed by a licensed healthcare professional to patients suffering from a medical condition. Examples of DME covered by Medicare include blood sugar meters, canes, crutches, hospital beds, nebulizers, walkers, wheelchairs, etc. These are intended to benefit patients suffering from long-term illness or chronic conditions in their daily life at home.
What is DME Billing?
DME billing refers to the process of preparing and submitting claims for the durable medical equipment provided. However, DME billing does not cover the equipment or device if used for convenience without a medical requirement of the patient. Examples of such devices include air conditioners and humidifiers.
What is DME Coding?
The DME billing companies, data analysts, and coding specialists use HCPCS (Healthcare Common Procedure Coding System) codes for submitting insurance claims. This DME coding system is a directory of all codes used in the DME billing services. These codes help keep track of the supplies and equipment provided to patients. As a result, it simplifies the processing of health insurance claims by Medicare and other insurers. For example, HCPCS code E0639 represents a moveable patient lift system, and E0603 represents an electric breast pump.
How to Streamline the Process of DME Billing?
Streamlining the process of DME billing can help in improved reimbursements for your medical practice. The following are some ways to make DME billing more efficient:
- Reduce errors to ensure correct documentation: Your DME billing will be effective only when the claim submissions are accurate. Errors in the DME codes or supporting documents can lead to claim rejection or denial, causing needless delays.
- Establish the medical use and necessity for the equipment: According to the DME insurance coverage guidelines, it is mandatory to show that DME has been used only for medical purposes in the presence of an illness, disease, or disability.
- Implement a robust billing system: A robust DME billing system will directly impact your DME billing process. It can help your healthcare practice stay updated when there is a change in DME guidelines. Moreover, it will help you keep a tab on rejections, denials, targets for denial correction, and more.
The Best Way to Optimize Your DME Billing Workflow? Outsource to MBSN!
Outsourcing DME billing can help you access the expertise of DME billing specialists. With Medical Billing Solutions Nationwide as your DME billing partner, you can stay updated on policy changes, payor guidelines, regulation updates, etc. Also, as a medical practitioner, outsourcing these services can help you focus on your core expertise, i.e., providing quality healthcare services to your patients. Get in touch with us to know more about our DME billing services.