Streamlining Hme/dme Billing for Better Revenue Cycle Management

Proper revenue cycle management in your healthcare organization is crucial for the smooth running of operations. With strict regulations and a changing insurance environment, medical providers must adopt billing systems that enhance cashflow and efficiency. Proper billing of durable medical equipment enables you to comply with regulations, receive reimbursements on time, boost the payer’s confidence, and optimize your healthcare business for better service. Let’s learn more about DME billing, its benefits, and associated challenges.

What is DME Billing?

When streamlining RCM, health organizations eliminate the use of paperwork through the adoption of an efficient DME billing software. Such cloud-based solutions provide the real-time status of DMEs, ensuring that medical facilities get the much-needed reimbursement. DMEs are medical equipment that is essential for improving the quality of life of patients. They include mobility aids, orthotics, prosthetics, CPAP machines and devices, hospital beds, and other medical devices, which a patient can’t do without.

DME billing is the process of capturing patient information, filing claims, and making follow-ups to receive payment from the payer. When physicians prescribe DME or HME for a patient, they must show that the equipment meets a medical purpose. Also, they have to code the equipment correctly and ensure it’s from a vendor approved by the payer. Ensuring that claims are error-free and submitted on time is critical for timely payments.

Who Carries Out DME/HME Billing?

It’s important to understand that the HME and DME billing process involves coding and the actual billing. Coding is whereby physicians input Healthcare Common Procedure Coding System (HCPCS) codes to identify a specific DME device. Professionals responsible for coding are referred to as coders. HCPCS codes allow DME vendors, DME rentals, and payers to track DME billing services to minimize denials and increase efficiency. DME billing can either be executed in-house by a healthcare organization or be outsourced to professional medical billers. 

Healthcare organizations can choose to hire data analysts to code and bill DME devices. If you choose this process, your company will be in control of the entire process. Your team will ensure compliance, manage denials, and conduct follow-ups. Large healthcare organizations can manage the costs of onsite DME billing but it can take more time and money for mid-sized and small clinics.

For that reason, most doctors choose to outsource the HME and DME billing process to professional medical billers. While you won’t have control of the process, you’ll transfer all billing costs and complexities to the third party. This allows you to concentrate on your line of practice and give more attention to your patients. Outsourcing agencies have tiered plans to suit the needs of every health organization. Assess the needs of your clinic to see if in-house or outsourcing is the best option for smooth RCM.

Manual Vs Software-Based DME Billing

Whether you’re a health organization or a professional medical biller, you need to choose between traditional manual billing and modern software-based billing solutions. Manual billing is burdensome as your team has to go through dozens of paperwork before submitting a claim. Manually filled forms also are prone to errors, something which increases the chances for denials. Unless you’re dealing with very few claims per month, manual billing is time-consuming and inefficient.

For clinics and billers dealing with multiple claims in a day, the manual process can be frustrating and costly. The use of DME software improves efficiency, eliminates errors, reduces denials, and promotes timely reimbursements. With software, you can integrate patients’ medical information in one place allowing you to file and follow up on claims easily.

Benefits of Using Software for DME Billing

HME and DME billing is challenging, and it gets worse if DME suppliers use paperwork. It will be a lot easier if your team can pull this supplier data into a digital cloud-based solution. Here are the benefits of using HME/DME software.

1. Real-Time Claims Tracking

Without software, you remain in the dark not knowing the status of your claims. Tracking patients’ history, insurance claims, and DME rentals is complex, overwhelming, and expensive. However, the software can keep track of all these processes in real-time enhancing efficiency in your medical practice.

2. Quick and Accurate Invoicing

With manual HME/DME billing, you can easily undercharge for services as you can fail to capture the true costs of the billing process itself.  Medical billing software captures all the costs involved in the billing process allowing you to bill DMEs correctly. In some software solutions, invoicing process is automated, making it simpler and faster to submit claims and collect payments.

3. Eliminating Human Errors

The process of preparing and submitting claims and receiving payments is long. If errors occur, it can be difficult to track where the mistakes occurred. A software solution greatly reduces errors and can easily pinpoint areas that need amendments before claims are submitted. With software, you reduce the number of denials and increase efficiency in your RCM.

4. Streamlining RCM

Overall, cloud-based HME/DME billing solutions smoothen revenue cycle management allowing doctors to receive payments on time. Such solutions unify back-end and front office document management, reducing coding errors in the process, and ensuring compliance in an evolving regulatory environment.

Denials of claims can disrupt operations, hurting healthcare organizations and patients alike. It, therefore, makes sense to adopt a solution that reduces denials and enhances the collection of payments. As a healthcare provider or a professional providing HME/DME billing service, consider cloud-based software that ensures timely collection of reimbursements.