DME billing and collection services can be a time-consuming and tedious affair. Among other things, it is not as easy as you think, as it requires in-depth knowledge and awareness of the changing reimbursement guidelines of Medicare, constant adherence to quality, Medicaid and Commercial Plans knowledge and their individual nuances; which for any in-house DME biller becomes difficult to be always updated. This is why fulfilling the perfect requirement for successful DME billing and collection services, many healthcare providers opt for outsourcing options for the seamless and profitable end. Now the question comes what are the requirement outsourcing operational extension should have for an efficient Revenue Cycle Management (RCM) process for you DME billing and collection.
In order to minimize the errors in your DME billing, having proper claims management and thereby rise in the Accounts Receivable (A/R) collections that provide healthy cash inflows, outsourcing DME billing and collection operational extension requires:
Trained Outsourced expertise:
For a successful DME billing and collection workflow, outsource experts who are employed in handling the billing, collection and claims submission need to be knowledgeable about the different rules and requirements for the billing process, codes, claims submissions, billing software knowledge etc. as even the slightest lack of information from the outsourcing RCM organization can see reimbursement rates drop by 50 percent at any given time.
Stringent Coding and authorization process:
Coders and prior authorization experts need to be well versed with the coding and all authorization rules and regulation, especially when it comes to DME services and the equipment used. As a minor error has the ability to transposed number in a claim code, entering an outdated modifier, wrong authorization approval can lead to a rejected or denied claim, leading to a huge loss of timely reimbursement.
Effective Claims Management process:
It is seen that many DME services lose an average of about seven% of their reimbursements due to rejections and/or denials and for not follow-ups of the claims. This is why follow-ups are very crucial for an effective DME billing workflow and A/R collection.
As DME suppliers are living in an era where increasing patient liability is adding to the growing struggle to maintain positive cash flow and keep their businesses afloat. There has been no easy button, but until now with Sunknowledge Services Inc being your operational extension.
Covering all aspects of DME billing and collection activities, our experts, in fact, take care of the complete DME responsibility in:
- · Order entry (patients, providers, insurance, items, etc)
- · Eligibility verification (both online and calling)
- · Prior authorization with patients calling and doctor’s office follow up for relevant documentation that needed for the process
- · Re- authorization
- · order Confirmation
- · Scheduling of delivery
Post billing services:
- · Claims management
- · Rejection management
- · Payment posting auto (with and without audit as well as manual)
- · Account receivable follow-up
- · Account receivable management and denial management
With 80% operational cost reduction and 99.9% accuracy rate Sunknowledge has the ability to provide unparalleled DME billing and collection solution.
Understanding the number of billing and coding challenges DME face, Sunknowledge Services experts are here to help out with all the complexity DME problems. In fact, with decades of experience, Sunknowledge Services expert offers the highest productivity metric with a service charge as low as $7 per hour. Providing a complete operational transparency and excellent industry credentials, we are one of the best solutions; helping clients focus on other important aspects like patient care and business growth. For more information about our billing and coding process, get in touch with our experts over a ‘no commitment call’.