Time to Resolve Your DME Medical Billing Problems

Today the DME billing process is growing far more complex and so its reimbursement especially with the ever changing rules and regulations. In fact, today the complex nature of the DME billing results in a loss of 3 percent of the overall revenue and reworking on a denied and rejected claim is nearly about USD 25 per claim. This leads to approximately $262 billion per year on denied claims according to a survey; sparking a huge cash-flow problems and recovery costs. However, in a DME billing process, the errors that lead to denial claims is a common mistake and can be avoidable. Studies have shown 80 percent of the denied claims can be recovered if we can reduce the common DME billing mistake.

In a DME billing process, denied and rejected claims often result of a clerical error, mismatched procedure, incomplete information, exceeded the date of submission of the claims or even due to the wrong ICD codes.

Here are the common reasons for the DME billing errors:

• Simple DME billing errors
• Incorrect patient information like the patient’s sex, name, DOB, insurance ID number, etc
• Late submission of the claims
• Incorrect provider’s information like their address, name, contact information, wrong policy number, etc
• Entering of incorrect codes like ICD, CPT or even HPCS, conflicting or confusing modifiers to HCPCS or CPT codes; entering too few or too many digits to an ICD, CPT, or HCPCS codes etc or even mismatched of the medical codes
• Duplicate billing is when it appears that a patient has received two identical treatments or procedures which would effectively double the amount sent to the payer; which is a huge problem.

How we can resolve denied and rejected DME claims issues?

1. Ensuring correct information during the time of submission- as even a small spelling mistake of a patient or demographic error can cause rejection of DME claims, which is why a person has to be very careful during documentation of the information.
2. Proper verification and check should be ensured – studies have shown that almost 75 percent of denial claims occurs when information is not properly verified, in fact, most of the time it is seen that a non-covered or ineligible service which often been missed during the verification process resulting in rejection of claims. Which is why outsourcing organization are here not only verify all the information properly but has a team of expert billers and coders to ensure every information is correctly incorporated before the submission of claims.
3. Ensures proper coding method – playing a vital role in helping the patient receive the right treatment, proper and correct codes also helps in the claims process and a faster reimbursement rate.

However, cutting down this simple DME billing errors in your medical billing process will not only help you with an efficient revenue generation but also a faster reimbursement. Helping you focus more on your core work, there are many outsourced RCM organization that not only t reduces your billing errors but also ensures 70 % of your operational cost reduction. With 99.9 percent accuracy rate and excellent industry references, these RCM organizations have the perfect robust redundancy plan ensuring you a seamless DME billing process.