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Rejections and denials of claims in DME billing greatly impact reimbursements and cash inflows of a DME billing company, and it hits directly the revenue cycle management process. With CMS bringing in close investigations on DME services, the relevant companies are to restructure their business concerns and activities. This helps them in streamlining their processes and improving their revenue as well. But the foremost thing to think of would be why such denials/rejections happen for most DME billing services.
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This blog can guide you with certain points as a checklist to understand why denials happen in general and how to deal with it before it goes to rejection.
#1: Check eligibility criteria for patient and do proper verification
The staff responsible for sending the applications for claims of a DME billing company should primarily focus on whether the patient is insured or covered for DME services and what are the eligible DME services for them. This checking is crucial and sometimes, spellings of names, incorrectly checked information box, etc. can be the reasons for a claim denial.
#2: Coding and modifiers
An invalid or a missed modifier can lead to immediate rejection of claims. To avoid this, you should keep a standard chart that notifies on correct codes and modifiers to your medical coders and billers. Whenever there is an addition/update on the coders and modifiers ensure that it is immediately reflected on your chart and your employees are informed about it.
#3: Documentation
Documentation is the next crucial one, which could lead to denial of claims when it is not sufficient or incorrect. Proper documentation has to support the medical necessity of any DME product prescribed. This acts as a helping hand not only during claims but also in audits to prove the claim is correct.
Every order should contain an indication of diagnosis/reason for using the equipment/medication, correct date, and the DME provider’s signature. Missing out any one can lead to rejection of claims. Therefore medical billers and coders should be very careful with documentation.
#4: Process and workflow
Before your initiate claims, it is important that you check and know about your internal processes, workflows and functionalities. If you identify a problem persists in the process by itself, changing the way you work, can save your time and effort of applying claims and receiving rejection status on them.
You can work out a dedicated and unique strategic plan for streamlining your DME billing process by creating a checklist for the key points aforementioned. Sorting out this points one by one will always keep you one step ahead and support you with reducing rejections/denials in DME billing claims.
You are not too late to follow certain processes to make your DME billing and workflow process streamlined. See if the following points can help you achieve your goal of reduced denials of DME bill claims.
· Revolutionizing and rebuilding your processes and organization structure can keep your staffs intact with the new rules and procedures.
· Updating the existing technology and adopting new platforms help in keeping processes in one direction and make you realize the pain point as well.
· Outsourcing your entire DME billing and claims process to an expert company can literally get the denials down and ensures smooth cash-inflows.
Conclusion:
24/7 Medical Billing Services is a medical billing and coding company that works rigorously and vigorously to get your claim reimbursements on-time. The company is well-known for achieving the maximum number of claims without encountering any rejections/denials in claims processing. Contact 24/7 MBS team if you face difficulty with reimbursements or have high volume of tasks to be completed.
Do you find it difficult to handle your DME billing? Do not worry. We are experts in dealing with all simple and complex claims.
Wheel chairs, walkers, and crutches relate to durable medical equipment (DME) billing category and require certain procedures to follow before and during billing. Most of the insurance providers may not cover DME supplies under any policy. Even Medicare covers only some equipment, which do not come under mobility, only on periodic circumstances. Yet, there are companies that provide coverage for DME supplies like Wheel chairs, Walkers, or Crutches but with following a stringent procedure. This article can help you with providing the piece of information you need to know for billing DME supplies.
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Requirements to be fulfilled for DME billing:
· To check whether your DME is eligible for coverage, you need to provide a prescription stating rent or purchase of the equipment, accordingly.
· There are certain items that you can only rent and cannot purchase. This comes under capped rentals, and based on the usage of equipment, the coverage depends as well.
· The rules may vary from one insurance provider to another. Certain companies do not encourage straight purchase of DME, but some may expect the DME to be rented first and then purchased. So depending on whom you tie-up with, follow the procedure properly.
· You should fill the CMS-1500 claim form (version 08/05) for claiming the DME bill.
· Provide the right HCPCS code to bill your relevant DME supplies. Make sure it includes but not limits to NU, RR, etc.
· Once you enter the procedure code, ensure you mention the maintenance and repair modifier codes.
· Before you submit all your claims, check whether you have provided detailed description of services provided.
· In case you do not have or find the right code for DME billing, use the code E1399 or any other miscellaneous HCPCS code. But while mentioning so, you should provide additional documentation for such DME claim if you enter miscellaneous codes.
The documentation should contain the following checklists before submitting the DME claim.
· Provide neat and complete description of DME claim you wish to proceed.
· If you are making the claim for the first time, enclose the factory invoice of the item. If it is proper, you should also get a certificate of medical necessity form duly signed by the physician. Note that you cannot include catalogues or retail price listings for additional documentation, since it cannot be accepted.
· Avoid stapling the documentation to the claim form.
· Submit all hand-written/hard copies of initial claim form to confirm that all documentation reaches for claim at a time.
· Note that additional documentation cannot be transferred if you have submitted your initial claim electronically.
Individual guidelines are available for every activity that you take up with your DME. Be it for purchase, rental, and reimbursement of DME, you should follow certain formal procedure. Before you purchase a DME, you should be aware whether it gets covered under insurance, and if so, you can keep documenting everything for the purpose of DME billing. If you opt for any DME add-ons or upgrades, it has a separate procedure for claims as well. Keep yourself updated for knowing latest changes or inclusions in the DME billing procedure in the future, which can avoid re submissions or mistakes while submitting the claim form.
Conclusion:
If you have any trouble with your DME billing/claims, you can approach 24/7 Medical Billing Services and get it resolved. We offer free consultation on any process related to DME and keep you away from confused state if any. 24/7 MBS is renowned for its high-quality and reliability in providing DME billing services and successful through achieving client satisfaction across.
Depending on professional Pathology Billing services experts like 24/7 Medical Billing Services is smart move. For further details, call us on 888-502-0537
The fact that ICD-10 Codes are the only identification criteria set for a medical disease is inevitable. They provide a common language to share data across various countries and platforms.
Apart from this, ICD-10 codes are a must in any medical billing process including pathology billing services. It is a necessary requirement to assign appropriate codes to pathology services like diagnostic tests and surgical procedures. This not only helps in filing a proper claim but also in maximizing reimbursements.
Replacing the old school ICD-9 Codes, this new edition consists of more than 68000 diagnosis codes 72000+ procedural codes.
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Here are the top 5 ICD-10 Codes for pathology billing services –
1. ICD-10-CM Code K29.50 – Unspecified chronic gastritis without bleeding
This billable code is used to specify the medical ailments related to gastritis, including terms like acute, chronic, antral, and fundal.
Gastritis is a condition of inflammation of the lining of the stomach. The episode may be small or long. Common symptoms include pain in the upper abdomen, bloating, nausea, vomiting, or loss of appetite.
2. ICD-10-CM Code N20.1 – Calculus of Ureter
N20.1 specifies medical conditions related to the complete obstruction of the urinary tract like ureteric calculus, occlusion of ureter, occlusion of ureter due to calculus, ureteral sludge, etc. The usual term used for such a condition is ‘Kidney Stones.’
Also known as nephrolith, they are solid pieces of materials formed in Kidneys because of minerals in the urine and create a blockage of the ureter. The situation usually causes pain in the lower back radiating to the groin.
3. ICD-10-CM Code C18.7 – Malignant neoplasm of sigmoid colon
This ICD-10 code is for medical billing in cases of Colorectal Cancer. It is used to refer to medical terms like carcinoma of sigmoid colon, adenocarcinoma of sigmoid colon, carcinoma of colon, lymphoma of sigmoid colon, lymphoma of colon, etc.
In simple terms, this condition specifies the development of cancer in the rectum due to the abnormal growth of cells. Common symptoms include weight loss, blood in stool, fatigue, and change in bowel movements.
4. ICD-10-CM Code C50.911 – Malignant neoplasm of unspecified site of right female breast
Now, this one’s limited to only females, the ICD-10 code helps specifies “Breast cancer” in women. Also, it includes a diagnosis for conditions like infiltrating duct carcinoma of bilateral female breasts, chronic disease of breast, infiltrating lobular carcinoma of the breast, etc.
One woman in eight suffers from breast cancer. Its symptoms include discharge from the nipple, a lump in the breast, or change in the size or shape of the breast. The condition is treated through surgery.
5. ICD-10-CM Code K20.8 – Other Esophagitis
The code specifies a medical diagnosis of allergic esophagitis which is an allergic inflammatory condition in the esophagus. The inflammation can be acute or chronic.
Symptoms include difficulty in swallowing food and heartburn. Diagnosis is carried out through procedures like upper endoscopy and biopsy. The condition can be treated by over-the-counter medicines or through some changes in diet.
It’s important for a pathology billing service to assign accurate ICD-10 Codes while billing. An error in such a task can prove to be fatal.
We at 24/7 MBS have a team of experts who have in depth knowledge of TeleHealth & TeleMedicines and are having years of experience in using the modifiers.
Telemedicine is the act of medication utilizing innovation to convey care with distance whereas Telehealth refers to a huge chain of collection of telecommunications and electronics that assist services and health care delivery from distance. Usually, Telehealth involves virtual education, medication and telemedicine support the relationship between doctor and patient through video calls or audio calls.
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Here are some of the modifiers that you should know –
Coding Modifiers in the sector of Medicare Telehealth industry:
In this dynamic world, changes in regulation are taking place now and there are specific changes that can affect the code for the services of telehealth. Much of the time, charging for telemedicine looks a mess like charging for face to face assessment and medication the board. But adding modifiers help a lot to overcome the complexion
Modifiers for Telehealth:
· GT Modifiers
GT is the most preferable modifier that is most usually utilized for telehealth claims. As per the AMA, the modifier signifies “through intelligent sound that can be audio call and video media communications frameworks.” You can add GT to any CPT code for administrations that were given by means of telemedicine.
· GQ modifier
GQ is the possibility for specific circumstances where asynchronous telemedicine can be proper. Per the AMA, GQ signifies, “Through an offbeat broadcast communications framework.” Asynchronous telemedicine implies that clinical consideration was given by means of picture and video that was not given continuously. A patient will experience assistance that is recorded as video or caught as a picture, and the supplier will assess it sometime in the future. Normally, the assessment is finished around the same time, however, there might be circumstances where that isn’t the situation. GQ is repaid by certain payers, yet the repayment isn’t as regular as the GT modifier.
Modifiers of Telehealth:
· CS- Modifier
The FFCRA forgoes cost-sharing for COVID-19 testing-related administrations for the Medicare Part B patients. Cost-sharing is deferred for office visits that bring about the request or organization of the COVID-19 test, or the assessment of a person to decide the requirement for such a test. The cost-sharing waiver is compelling for dates of administration beginning March 18, 2020, until the finish of the general wellbeing crisis.
· Modifier 95
Telemedicine is the act of medication utilizing innovation to convey care with distance whereas Telehealth refers to a huge chain of collection of telecommunications and electronics that assist services and health care delivery from distance. Usually, Telehealth involves virtual education, medication and telemedicine support the relationship between doctor and patient through video calls or audio calls.
We at 24/7 Medical Billing Services understand the need of the hour & provide assistance related to the telehealth & telemedicine. We provide our services to hospitals, specialists, and medical billing service providers to help them in easing the work.
If you feel you are stuck with billing & coding for Tele Health & Tele Medicine. Partner with us & see the difference with your revenue generation on a month-on-month basis.
Expert Medical Billing Outsourcing Services that guarantees higher revenue for your practice with the best medical billing practices
What is Medical Billing?
When it comes to settling payments from insurance companies, medical practitioners, hospitals, and healthcare facilities face a lot of hassles. For the patients, the bill is settled once they provide the details of their insurance at the front desk of the healthcare facility. However, the hospital or healthcare center receives the reimbursements only when the claim is settled by the insurance companies.
Medical billing refers to the process of filing and following up on claims with health insurance companies / providers in order to receive payments for the healthcare services rendered to patients by the practices / physicians. Medical billing serves as an effective channel between medical service providers and insurance companies.
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Need of Medical Billing Services
With time, as the medical practice scales to new heights and grows, medical practitioners, doctors, and healthcare providers would need to delegate the medical billing task by hiring an in-house team of experts or outsourcing the task to a medical billing service provider.
The objectives of medical billing services are as follows:
· Boost the profitability of medical practitioners and healthcare centers
· Streamline everything from start to end (Patient Appointment Scheduling to Collections)
· Leverage on coding expertise and technical knowledge to maximize revenue generation from insurance payments
· Reduce the chances of claim denials
· A/R Follow up to reduce the accumulated A/R
Common challenges faced by Physicians and Practitioners with Medical Billing
· Lack of quality and effective medical billing resources
· Lack of appropriate tools and techniques to minimize revenue loss
· Staying up-to-date with the latest guidelines
· Inaccurate data entry for patient information
· Frequently changing medical billing codes increase the chances of claim denials
· Old redundant software and the capital investment to upgrade it frequently
· Duplicate charges or multiple billing for a patient
· Late handling of denied or rejected claims
· Delayed claim submissions
Cons of In-house Medical Billing:
In-house billing refers to the process of handling all the medical billing aspects by a medical practitioner’s own expert in-house team.
However, keeping everything in-house has a lot of disadvantages.
1) Highly Expensive
Having an in-house medical billing practice involves a lot of capital expenditure and investment in getting a medical billing software and recruiting a team that knows how to operate the software. The cost incurred for recruiting, training and salaries of the medical billing team would definitely be more than the cost to outsource.
2) Support Issues
A major drawback of having an in-house medical billing team is the ability to provide the required support to the clients. If a limited number of medical billers are hired, it would be difficult to handle a larger client base. On the contrary, having a large team for limited number of clients means more expense for the business.
3) Liabilities
Having an in-house medical billing team means that they need to be constantly monitored with regards to the security protocols and compliance guidelines followed by them. Any violations of PHI security or protocols can result in huge liabilities for the company. In order to get rid of the liabilities, a lot of cash inflow needs to take place.
Need for Outsourcing Medical Billing Services
Outsourcing medical billing refers to the hiring of an external agency by a healthcare provider who takes care of all the medical billing aspects.
Outsourcing is an effective way to manage medical billing. According to Verified Market Research, the medical billing outsourcing market worldwide was valued at 7.4 billion USD in 2018 and is expected to reach 15.6 billion USD by 2026.
In reality, medical billing can be quite tedious and a time-consuming task for medical practitioners. In order to overcome this, it makes sense for them to outsource the processing of medical claims. This would allow them to free up both time and space, thus enabling them to focus on what they do best, i.e. take proper care of the patients. Choosing the option to outsource limits their liability and helps to save capital in the long term.
Benefits of Medical Billing Outsourcing
1) Boost in revenue generation
Medical billing outsourcing helps healthcare providers, especially small practices to collect more money and improve cash flow. This is because collection rate improves with timely submission of medical claims. This increases the inflow of reimbursements from the side of the insurance companies.
2) Compliance with ICD-10
The latest version of the International Classification of Diseases (ICD), i.e. ICD-10 is a growing concern in the healthcare and medical industry. The new coding changes as per ICD-10 has resulted in a severe impact on the reimbursements of healthcare providers. Outsourcing medical billing means that compliance regulations and coding changes of ICD-10 will be taken care of by the service provider.
3) Saves money
One major benefit of outsourcing medical billing is that it is cost effective and helps healthcare providers and medical practitioners save money. The infrastructure, expertise and procedures, everything comes at a lesser price when outsourced. Thus, outsourcing medical billing is a profitable decision.
4) Improved focus on patients
By outsourcing billing, medical practitioners can spend more time with their patients and offer better services to them. This is because they do not have to look into the medical billing work. More focus and attention to patients means more satisfaction and quality patient care.
5) A/R follow-up
The accounts receivable (A/R) follow-up by the outsourced medical billing company ensures easy recovery of overdue payments from the insurance companies. The A/R follow-up team takes care of the denied claims and reopens them to get the maximum compensation from the insurance companies.
6) Denial management
The main aim of the denial management process in outsourcing medical billing is that it focuses on minimizing the lost reimbursements and denials with highly efficient systems and solutions. The denial management team of the outsourced company works on resolving the problems that lead to denials and strives to cut-short the accounts receivables cycle.
7) HIPPA Compliance
While choosing to partner with a medical billing service provider, it is necessary to ensure that the company is HIPPA (Health Insurance Portability and Accountability Act) compliant. An HIPPA compliant medical billing service provider needs to ensure that all the patient’s records and personal information is kept completely secure and confidential. HIPPA compliance requires healthcare entities to ensure complete privacy of patients’ sensitive information.
8) Reduced Billing Errors
Outsourcing medical billing services helps medical practitioners to minimize billing errors. The medical billing service provider leverages on various technologies to reduce billing errors. Any medical billing mistake results in loss of reimbursements, thereby affecting the revenue. Medical billing errors can be reduced by ensuring and verifying that all the patient details are correct, investing in training and avoiding duplicate claims.
Why choose 24/7 Medical Billing Services?
· One stop shop solution for all your medical billing needs
· Customized services depending on the nature of your challenge
· Improved cash flow and collection rate of your healthcare center
· Multi-level authentication and security system in place for data security
· Reduced operational costs of your medical center
· Fixed cost for all services with no hidden charges
· Strict deadlines for reimbursements from insurance companies
· CPT and ICD-10 coding compliance eliminates hassles in filing a claim
· Skilled expertise in different domains
· Competitive pricing for all medical billing related services
· Flexible plans depending on your requirements
· Complete transparency for all procedures
· Detailed reporting of your account’s receivables
24/ Medical Billing Services has been in the industry for more than 12 years now & We have been offering end-to-end Revenue Cycle Management services for huge practices & multi-specialty clinics. We specialize in Durable Medical Equipment (DME) Medical Billing, Chiropractic Medical Billing, Tele-Health Billing & close to 40 other specialties.
Free Credentialing
Credentialing is a key step of becoming a trusted medical practitioner and healthcare provider in the list of medical insurance companies in the market. It is essential for healthcare service providers to be a part of the insurance company’s network. If they are not a part of the list, many patients may refuse to take treatment.
At 24/7 Medical Billing Services, as a part of an on-going promotional offer, we are providing free insurance credentialing to doctors, hospitals, and small practices who partner with u as a part of the medical billing services. We verify and update the credentials of healthcare providers with insurance companies at regular time intervals. Credentialing serves as an effective medium to be recognized by insurance companies and get paid by them for the services rendered to patients.
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20% of Americans live in provincial territories, however, they are just served by nine percent of the care section of the health industry.
Tele-medicine is a route for these patients to have the option to cooperate with suppliers when it might be troublesome or illogical to see them face to face. These kinds of experiences could give income to the supplier while additionally improving patient consistency and diminishing their costs related with transportation.
Enormous private payers perceive the potential cost investment funds and improved well being results that tele-medicine can help accomplish; hence they are regularly ready to cover it. While there are a few contemplation, there could be sure conditions where tele-medicine may opt to apply for chiropractic care.
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Available codes for billing in Chiropractic
Codes accessible to Chiropractors to charge as a feature of the transitory extension of tele-health administrations, because of the COVID-19 national general well being crisis.
1. 99201: office or outpatient can visit new patient
2. 99211: office or outpatient can visit only established patients
3. 97110: exercises related to Therapeutic
4. 97116: therapy for gait training
5. 97530: contact with patient (approx. 15 minutes), exercises related to Therapeutic
6. 97112: Neuromuscular re-education
7. 97535: training for self-care and managing self
These are just a few codes, there are many other codes, some related to orthotic management, 1st encounter and so on.
When charging for tele-medicine, the spot of administration code that goes in 24b on the 1500 case structure ought to be 02 to show telehealth. Ordinarily, the 95 modifiers ought to likewise be joined to the CPT code.
Options available for modifiers
1. GQ Modifiers: this is made through telecommunication system that is asynchronous
2. GT Modifiers : Audio and video are the options through which interaction is done with telecommunication systems.
3. Modifier 95: Coordinated Telemedicine Service Rendered Via a Real-Time Interactive Audio and Video Telecommunications System
There is some additional documentation required which differs from person to person.
Documents are:
1. DOS that is date of service
2. Patients location and also provider’s location
3. Start date and end date
4. Is it meeting the eligibility and criteria of CPT code
5. Telemedicine services should be mentioned
6. Symptoms for selecting a particular code
A few people think telemedicine has restricted application in a chiropractic setting. Be that as it may, it might permit patients to be better off and suppliers to produce extra income. In this way, telemedicine will probably merit consideration for DCs later on.
With this, you might have got a clear idea regarding how important it is to have medical coders & billers who are well-versed with chiropractic billing. We at 24/7 Medical Billing Services have a team of well-trained & certified experts who are equipped for filing & tracking all the chiropractic claims.
Availing our services will not only help you in increasing the reimbursements, but will also help in identifying the loopholes that are hindering your growth process.
We at 24/7 Medical Billing Services provide telehealth & telemedicine services. If you need any assistance, contact us @ +1 888-502-0537
During this pandemic, telehealth has made a very positive contribution to healthcare. It is bridging the gap between the patients & physicians, enabling everyone to stay at home & communicate through the virtual channel, reducing the spread of virus among the masses.
Telemedicine is the use of a digital platform that involves online diagnosis & treatment of people through voice calls, video-calls, and various other electronic mediums. The process starts after the person registers himself. After that the diagnosis is done by the doctor on a video call & e-prescription is provided. It helps in bringing the doctor & patients together more effectively.
Let’s have a look at the benefits of the Telemedicine –
· Convenient & accessible
Telemedicine has not just broken the geographical barriers, but has made the entire healthcare delivery model more convenient to the patients.
· Cost-effective
By reducing the problems like medication non-adherence, unnecessary ER visits, and making typical doctor visits more efficient, telemedicine has the power of cutting the cost on healthcare.
· Increasing engagements
It helps in increasing the engagement by allowing the patients to connect with their doctor more frequently, in a convenient way. This means now they can interact more and build a strong doctor patient relationship.
· Better quality
Use of remote patient monitoring systems helps in maintaining a better quality, that leads to better quality outcomes.
Let’s see what are the limitations of Telemedicine & how hospitals are adapting to it –
· It requires technical training & various equipment’s
Telemedicine platforms that are used between primary doctors and consulting specialists require extensive training and the purchase of a telemedicine cart and various other mobile health devices.
· It reduces the interpersonal contact
Telemedicine interactions are impersonal & some people argue that it does not help in full diagnosis & face to face interactions are much more valuable & necessary.
· Reimbursements are difficult
Telemedicine reimbursements can be difficult as compared to the normal ones. It can be because of the changing policies. One of the best ways to navigate the reimbursement is to call up your top payers and ask their policies.
It has been accepted that telemedicine is here to stay & continue the future healthcare practices. It will promote the safe, effective & efficient telehealth services in the healthcare sector. We at 24/7 Medical Billing Services provide telehealth & telemedicine services. If you need any assistance, you can contact us! We are there to help you round the clock.
DME Billing Services- Major Changes Expected in 2020
DME Billing Service
DME billing is vastly different from other medical billing procedures. To carry out the process of DME billing efficiently is a tedious task. It requires a lot of in-depth knowledge of all HCPCS(Healthcare Common Procedure Coding System) level 2 codes. The nature of reimbursement is also quite complex. However, after coding, the invoice documents CatLog needs to be compelled for electronic claims submission.
Missing documents can result in delays or negation of payment. So, you need expert DME billing services to claim codes correctly. Post medical coding, the claims need to be submitted to the insurance company. Thus, a reliable and professional medical billing company ensures correct and timely filing for accurate claims. DME billing requires high-grade coding by experienced coders. The most DME items have appointed codes which are known by the experienced coders only.
Major Changes Expected In DME billing Services in 2020
1) It is expected that the Durable Medical Equipment industry might see a massive jump in market size in the upcoming years. A new study reveals that the global DME market may reach 246.6 billion dollars by 2026.
2) The current segmentation in the global DME market is based on device type, end-user, and region. The hospital and clinic segment will again capture the largest market share. The reason behind this is the higher influx of patients to hospitals with greater financial spending.
3) The rise in competition between DME billing service providers is on a different level. The radical technological advancements in the medical sector all over the globe are also increasing the number of players in the market.
4) North America dominated the DME market and will continue to do so. The foremost reason the United States being the largest contributor to its revenue. The USA has such a stronghold on the market that more than 40% of global DME's are from a single country. In the coming years, they will retain and continue to dominate the market.
5) In the device segmentation of the Durable Medical Equipment, the therapeutic and monitoring devices are estimated to grow at a higher pace than others in the coming years.
6) A 6% CAGR(Compound annual growth rate) between 2019- 2025 is expected in the DME sector by the latest MRFR( Market Research Future Report).
7) The DME billing outsourcing services will continue to adopt better Revenue Cycle Management. Furthermore, adding to changes in Evolution and Management coding (E&M coding) in 2019 to reduce complexity and facilitate quick reimbursement.
Adoption of better Electronic Health Record software and vendor will give a hassle-free passage to the clients. The market is getting bigger for DME's. The demand for the equipment is creeping up due to various healthcare initiatives all around the globe.
However, the billing services are still a big issue for the patients. Expert, reliable & accurate outsourcing billing services come into the picture here to provide them relief and ease the burden on them.
Looking for support for mental health billing process? We at 24/7 Medical Billing Services have team of experts that can help you in error free & timely billing.
Focus on providing services to the patients, let us take care of your billing & claims!
Are you constantly worried about the challenges involved in the mental health medical billing services? Are you not able to deal with the drop in the ROI & delay in reimbursements?
Mental health billing is one of the most important parts of the medical billing that undergoes timely changes in the coding, rules & regulations. And it can prove to be a nightmare in case you do not have experienced billers & coders for mental health billing.
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Here the services are provided by the counselors, psychiatrists, & psychologists & rather than billing for a specific task, the billing is done for the therapy sessions. A strong understanding is required regarding various codes related to the mental health billing.
Outsourcing your mental health billing services to 24/7 Medical Billing Services can be one of the easiest solutions. We can take care of everything at just $8 per hour. We offer a wide understanding of mental health billing, fair pricing and integration with more modern mental health billing practices.
Unsure if you should outsource these services? Let’s have a look at the benefits of it –
· Accuracy
The mental health diagnosis changes every year & it is not possible to have knowledge of all. We have a team of experts who looks after mental health billing. So, outsourcing can give more accurate results.
· Saves a lot of time
The paper work involving insurance claims delay, submission, & resubmission can cost a lot of time. Outsourcing the work to billing professionals can save a lot of time that the practitioners can invest in focusing on the clients.
· Keeping you on the top of HIPAA compliance
The team has years of experience & in-depth knowledge of filing claims. It makes sure that the billing is according to the HIPAA compliance.
· Security & privacy
The team maintains the complete security of the data & makes the security policy transparent. You can be sure that you are in the right hands.
· Increased collections
The team makes sure about the settlement of claims, which in turn leads to increase in collection & revenue. This helps in increasing the overall ROI (Return On Investment).
Looking for support for the mental health billing process?
We at 24/7 Medical Billing Services have a team of experts that can help you in error free & timely billing. And we are offering this service at a very affordable rate of just $8 per hour.
Let us put our years of experience to work for you & offer you the best services.
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The first step to avoid all forms of revenue leakage in DME billing and coding is to identify the loopholes.
Revenue leakages are a major concern in the healthcare industry. They are the difference in the claimed amount that healthcare providers are entitled to receive versus the amount of the reimbursement they actually receive. This phenomenon is especially common in the Durable Medical Equipment (DME) billing & coding industry because of the inherent cumbersome nature of DME billing.
· As per the Harvard Business Review, the top hospitals have lost hundreds of millions of dollars of income due to revenue leakages.
· As per American Hospital Association, all kinds of U.S. hospitals reported approximately $620 billion in uncompensated care costs since 2000.
Top reasons why revenue leakages happen in DME billing and coding:
· Denial of claims: 20% of all revenue loss is due to denial of claims. Claims can majorly be denied if:
1. Demographic Information of the patient is incomplete.
2. Information is missing or invalid.
3. Medical Necessity of DME usage is not clearly mentioned.
4. CPT code, Modifier, PIN, or NPI is incorrect or missing.
5. Duplicate claim or service is found.
· Inaccurate codes: Another common reason for revenue leakage is incorrect coding of accessories or equipment. Only when the DME biller identifies the right HCPCS level II codes and sends over the claim with authorization paperwork, the insurance company will pay the claim.
· Non-compliance: All the guidelines laid down by the Health Insurance Portability and Accountability Act (HIPAA) and the Office of the Inspector General (OIG) must be followed to the last bit in order to prevent complete rejection of your claims and thereby leakages in revenue.
· Lack of real-time monitoring: There’s no substitute to correct and real-time data. If that’s not available and there are discrepancies in your data, be sure of major revenue leakages. Why? Because without real-time data, decisions will not be backed up by accurate data. For example, if the insurance policy does not cover a specific treatment, this can be communicated to the patient and the provider beforehand so that there are no issues in the DME billing.
· Incorrect data: Inaccurate data entry in the database can give rise to mismanagement of funds and thereby revenue leakage. Until the data is meticulously collected and analyzed by experts, error-free billing is a distant dream.
· Failure to Follow-up: Failure to follow-up regularly can sometimes lead to non-payment of claims. If there’s a delay or the claims are outrightly rejected, DME billers need to follow up or resubmit the claims to avoid revenue leakage.
· Lack of expert guidance: By now you know that DME billing is an exhaustive process and must not be handled without expert guidance. Revenue leakages mainly happen when non-professionals venture into it and do not adopt DME billing outsourcing. Billing professionals can help you avoid errors, identify loopholes, get payments on time, manage denials and rejections of claims, and streamline the entire billing process so that you receive the payments you deserve.
The first step to avoid all forms of revenue leakage in DME billing and coding is to identify the loopholes. By giving the process in the hands of experts, you ensure that you’re focusing on what you’re best at – treating patients, which by the way will lead to revenue generation in the long run.
About 24/7 Medical Billing Services
24/7 Medical Billing Services is the nation’s leading medical billing service provider catering services to more than 43 specialties across the entire 50 states. You can rely on us for end-to-end revenue cycle management. We guarantee up to 10-20% increase in the revenue with cost reduction of your practice for up to 50%. Call us today at 888-502-0537 to know more on how we can help boost profitability for your practice.
24/7 MBS is one such company that has met all the aforementioned expectations and gained expertise over time. DME Billing Service Provider
Provider credentialing is a popular term among those who want to start their own durable medical equipment (DME) billing business. Starting a DME billing business is not as easy as you see it. Like other businesses, DME billing also incurs a lot of groundwork and neat establishment. But one good thing with this business is unless you get everything right, you may not be able to start with. So in the future, you need not break your head with any complexities involved in the business.
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In today’s scenario, the biggest challenge that you may face with DME billing is collecting payments from your clients /patients. Due to the number of companies offering insurance with a wide range of benefits to their employees, it becomes a hard task for DME billing companies to deal with. But, even success also lies in the same factor. Therefore, you will likely be handling the burden of accepting the insurance, billing the insurance company, and receiving funds from the insurance company on time.
Let us take a deeper look into the credentialing process for DME billing.
How and whom to approach for DME billing credentialing?
Finding the best insurance company to network with is a long and tough task as well. Sticking onto one big insurance company does not work well for running your business. You should tie up with both private and public companies of various types and allow patients to use their insurance card with you. You should also understand the fact that choosing the best insurance companies for your DME medical billing company takes a good time.
You can see certain small insurance companies that have more employees, which yields great profitability to your company. You should consider such companies as well. Therefore, the list of insurance companies you collaborate with should be a combination of all three to engage more patients using your facility for consultation and medication.
What is the process of obtaining DME Billing credentialing?
· First, you need an office space for establishing your business.
· Open a bank account for your business.
· Acquire a business name for your organization and a stabilized location.
· Now you require licensing information, background, portfolio, website, company safety insurance. Make sure that you have the application signed and legally documented and obtain a unique Federal Tax ID#.
The approval/denial of DME billing provider credentialing takes at least 90 to 120 business days for 8–12 carriers. After which you continue with contracting which shows your eligibility criteria for networking with insurance providers. You receive a contact form to be duly signed by you and sent back to the insurance company, and in the next 30-60 days, your contract gets confirmed. Remember that it is not a wise idea to acquire networking with an insurance provider after you establish your company and run the business as usual.
How to begin with the credentialing process?
Instead of getting involved by yourself in the credentialing process, hire specialists who can take your burden on their heads. Leave the entire process to them right from acquiring the insurance partner, application form filling, and follow-up with insurance companies and focus on your potential customers. There are many agencies available for handling the same. First select companies that are mostly within your proximity or in main areas of the city and get quotations from the shortlisted ones. Finally, choose the one you are comfortable with.
Conclusion:
24/7 Medical Billing Services is one such company that has met all the aforementioned expectations and gained expertise over time. The process was initially so crucial because you will be in an urge to establish your DME billing company. But rather than just establishment, you should think over the stability and facility that customers expect from your end. The secondary aspect of your focus should be on hiring a team that can work without compromising on quality and service, whereas the first comes to the insurance provider.
Be sure about your needs and what could make you successful before you begin with. Definitely, it will help you gain popularity and potential customers, vendors, or suppliers as a betterment. 24/7 MBS is successful because of not only their quality of service but also staying in line with the latest trend and wish to be up-to-date in every stage.
About 24/7 Medical Billing Services
24/7 Medical Billing Services is the nation’s leading medical billing service provider catering services to more than 43 specialties across the entire 50 states. You can rely on us for end-to-end revenue cycle management. We guarantee up to 10-20% increase in the revenue with cost reduction of your practice for up to 50%. Call us today at 888-502-0537 to know more on how we can help boost profitability for your practice.
DME supply is an ever-growing and on-demand business, which can yield you profits for the money and time you invest in.
It is natural that people get sick and approach healthcare centers for treatment/consultation irrespective of the state of the economy. This is one of the reasons that make hospitals and healthcare-related businesses stay away from recession. Due to the increase in the need for healthcare services among the public, we see a rise in the number of healthcare and related facilities as well. But what drives these facilities to be successful are essential medical supplies in surplus, which has been a motivational factor for starting a DME store.
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Especially, during this pandemic, people definitely look out for healthcare centers/stores which offer great benefits. Therefore, you cannot find a better time to set up your DME store than considering the current scenario. Giant companies already exist in the market supplying a huge amount of medical supplies to healthcare facilities; yet, there is a large scope for independent DME stores to establish their business as well.
Before you implement your idea of setting up a DME store, it is ideal that you know whether there is a need for the same in your place. Otherwise, your business will be listed just as another business if not serving any demand.
Why go for a medical supply business?
Starting your own business is a great idea because you can be your own boss, and it creates financial freedom as you expect. DME supply is an ever-growing and on-demand business, which can yield you profits for the money and time you invest in.
You can create a brand image for your business by specializing in a certain line of products. Opening a DME store is a cost-effective way to enter the medical field that allows you to develop in no time. To develop a successful DME medical supply business, all you require is proper research in the background. You should be fully aware of the loopholes and look for opportunities in every gap since the industry is large.
You can opt for both in-store and online DME medical supply business and reach your customers anytime.
What factors should be considered for setting up a DME store?
To start your ideal DME supplies store, here are certain criteria you can follow:
#1: Think of which best method can help you operate your DME medical supply business. You can open a physical store, make it available on your own e-commerce website, sell it on any e-commerce platform that accepts medical supplies, or combination of both.
#2: For opening a physical DME store, you require a perfect location. In case you prefer to go for an online business, you can operate the business from your home. You can rent or lease a commercial property that suits your business requirements.
#3: Now you should look at the possible markets you can bring into your DME business. Some of it includes durable medical equipment, dedicated equipment that provides continuous positive airway pressure and several respiratory equipment, etc. You can choose your own niche and enter the DME supply market.
#4: Hunt down potential office locations near doctor’s clinics, hospitals, and similar ones. Only when you are exposed to medical providers, you get patients through the reference.
#5: Acquire a business license from your local city so you can manage anything within your proximity.
#6: Liberalise the personal needs of your DME office. Work out the best market plan that serves your business needs in terms of hiring talented resources across verticals such as equipment repair and maintenance, walkers, wheelchairs, hospital beds, and wheelchairs that function using the battery.
#7: Get a few people at the reception who can handle multitasking that improves your customer satisfaction, and at the same time, engage more customers based on responses you provide them.
5 Best keys for showing development in your DME supply store
You should try implementing the following 5 attributes to develop DME business in your pharmaceutical store, explicitly
#1: More appearance more attention
Make your products more visible to customers who walk-in to your store. This helps you with the maximum reach of your store products.
#2: Engage well-trained staff
Appointing dedicated and well-trained staff in the DME Billing section projects your business as an organized one. Likewise, allocate staff to every section based on their potential and skillset. Your staffs remain up-to-date on technologies in this way.
#3: Educate providers
Conduct training sessions/ conferences/seminars for your medical providers and make them understand the challenges you face in DME billing business concerning insurance coverage.
#4: Stay in line with the latest trend
Gain awareness about newly launched products in the market and know what a DME supply business is likely to offer and how to bill for it. You should be able to offer the recommended product based on demand; if so, you can introduce new products.
#5: Maintain a stable cash flow
In the DME supply business, you might face challenges like lower payments, late reimbursements, and frequent audits. Offer a variety of products and keep your customers intact with your store. This ensures that you always have cash inflow in your business.
Conclusion:
There are many things you should take into consideration before you start a DME supply store of your own. The information provided in this blog can guide you through the establishment stages. You will know how to deal with things as in when you move from one stage to another in facilitating your store.
About 24/7 Medical Billing Services
24/7 Medical Billing Services is the nation’s leading medical billing service provider catering services to more than 43 specialties across the entire 50 states. You can rely on us for end-to-end revenue cycle management. We guarantee up to 10-20% increase in the revenue with cost reduction of your practice for up to 50%. Call us today at 888-502-0537 to know more on how we can help boost profitability for your practice.
Leading Medical Billing Services | Medical Billing Service Companies | Best Medical Billing Services | Outsourcing Medical Billing Services
Are you entangled between billing your patient and giving him the best healthcare service? If so, then you should search for the Medical Billing Service Provider, that knows how to use the decoders and modifiers and can do all the administrative and financial work for you. So, you can focus more on providing the best healthcare services to your society.
Looking for a Quote? Let's Connect http://www.247medicalbillingservices.com/dme-medical-billing-services-at-only-usd-8-per-hour/
For all the practitioners and healthcare providers, here are some of the top medical billing service providers you can ever find.
· 24/7 Medical Billing Services – A HIPAA certified multi-specialty expertise in medical billing service providers. From ensuring a high level of data security to transparency in procedure and charges. 24/7 Medical Billing Services offer services that smoothly and efficiently runs the office operation from patient appointments to account receivable follow-ups. As per its customers feedback, around 50% operation cost is deflated and 15% revenue is inflated. It has the best coders and modifiers and is also most suitable for insurance credentialing.
· AdvancedMD – Software that unites the business and clinical aspect of the company. It enables three different aspects of the work i.e. health records, patient management and practice management to be maintained in order automatically. They have the best EHR software’s to let you have access to all its patients’ healthcare information. AdvancedMD software runs on the MAC and Windows Operating System in Desktop and iOS and Android Mobile Phone.
· CureMD – It is an all-in-one solution for the healthcare providers. In usage of the cloud technology, it integrates and disperse the information among multiple platforms. CureMD streamline the business operation in line with the ensured industry standard and practices. In a highly competitive scenario today, it makes sure to be ahead in terms of revenue and services with its flexible approach.
· Kareo – A web-based medical billing service provider across the United States. More suitable for small establishments in scheduling patients to make payments to customized records. It has an additional built-in messaging feature to let you reach billers, patients and your employees whenever you want. It is an ICD-10 Medical Compliant Solution software that is used in Chiropractic, Pediatrics and many more medical specialties.
· NueMD – It offers cloud-based software’s for all medical practitioners. Apart from the practice management to the electronic health recording, it also consists of additional features that made it to the top 5 medical billing service providers. Credit-card processing and one-click away paper claim. You can also opt for a monthly subscription to start with.
Now you have the best medical billing service providers in front of you to choose from. Choose wisely, otherwise your bottom line will get affected.
About 24/7 Medical Billing Services
24/7 Medical Billing Services is the nation’s leading medical billing service provider catering services to more than 43 specialties across the entire 50 states. You can rely on us for end-to-end revenue cycle management. We guarantee up to 10-20% increase in the revenue with cost reduction of your practice for up to 50%. Call us today at 888-502-0537 to know more on how we can help boost profitability for your practice.
Medicare is an insurance program, offered by the federal social committee and popular among DME billing companies and customers as well.
Medicare is an insurance program, offered by the federal social committee and popular among DME billing companies and customers as well. It focuses primarily on older and disabled people. Medicare holds a share of 21% in terms of U.S healthcare expenses and 17.8% of Americans based out of the U.S have been covered by Medicare. Therefore, most of the DME billing companies first prefer enrolling in insurance programs offered by Medicare.
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DME Billing
If you are a new DMEPOS supplier, you should definitely register your business with the Medicare enrollment application to become qualified to get paid for insured customers through Medicare. This blog takes you through the complete Medicare procedures for DME billing and how it is effective as well.
The application form provided by Medicare requires you to fill in all the information about you and secures only the needed documentation. This cross check’s your eligibility criteria before you apply for DMEPOS with Medicare and then allows you to enroll in the program.
How to enroll in Medicare?
The Medicare enrollment process is very simple and quick as well.
· First, the National Supplier Clearinghouse (NSC) initiates and progresses your enrollment application and proceeds with the verification of your information.
· In case NSC asks for more information in the due course, you should be in a position to provide the same.
· You should respond to the mail requests sent by NSC immediately; showing a delay in response can lead to further delay in your enrollment.
Enrollment process
The following procedure is for becoming a DMEPOS (Durable medical equipment, Prosthetic, Orthotics, and Supplies) supplier.
Step 1: The applicant fills and submits the Medicare enrollment application form and the respective documents to the NSC.
Step 2: The NSC validates the application and carries out a site visit to ensure and mark compliance with all DMEPOS supplier standards.
Step 3: Once the verification is complete, the NSC informs the applicant through mails about the status of their decision towards the applicant’s enrollment application.
If you have any information to be changed in the Medicare enrollment application form, you should inform the NSC within 30 days of applying. You do not have to grab a new enrollment form; instead, you can make use of your existing application form and mention, highlight the changes alone.
Before we get close to the final step in the Medicare program enrollment procedure, you must know about the term Participation. Participation is more or less similar to accepting assignment of claims every time for all services you offer to beneficiaries of Medicare. It also ensures that you collect payments as one-time and do not claim other than Medicare deductible or coinsurance of the beneficiary if any. Though you agree to the point of participation or not, according to the Social Security Act, Medicare expects you to submit claims for its beneficiaries without fail.
The participation benefits you in several ways. As a DMEPOS supplier, you receive the payments directly from Medicare because they are all assigned. The claim information is transferred to Mediated insurers i.e. for medical supplemental coverage.
Medicare enrolment and registration
The standard healthcare transactions in recent times are controlled by the National Provider Identifier (NPI) over the healthcare provider identifiers. So it becomes an unleveraged rule for DMEPOS suppliers to acquire the NPI before they intend to enroll in Medicare programs. Only if you do this, you will be able to bill and be paid for services offered to Medicare beneficiaries.
Conclusion:
24/7 Medical Billing Services is one such company that tops when it comes to DME billing and coding, helping independent doctors, nursing homes, hospitals across the United States, by handling their medical billing effortlessly and efficiently. The best part with 24/7 is they are experts in Credentialing, A/R Follow up and denial management services across the nation.
About 24/7 Medical Billing Services
24/7 Medical Billing Services is the nation’s leading medical billing service provider catering services to more than 43 specialties across the entire 50 states. You can rely on us for end-to-end revenue cycle management. We guarantee up to 10-20% increase in the revenue with cost reduction of your practice for up to 50%. Call us today at 888-502-0537 to know more on how we can help boost profitability for your practice.
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