How HME Billing Differ From DME Billing?

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How HME Billing Differ From DME Billing?
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How HME Billing Differ From DME Billing?
You need to build strong foundation for your
medical equipment billing system for which you
should understand HME billing and DME billing in
detail along with differences between them. Lets
start with the basics. HME billing and DME
billing are two main types of billing for medical
equipment providers. It is observed that there is
hardly any difference between DME billing or HME
billing is concerned. DME and HME service
suppliers need to meet the eligibility or the
credentialing requirements as set by respective
insurance companies. DME Billing DME is referred
as all the equipment prescribed by a physician
based on a medical need for patients. In this
type of billing the location of the item being
used did not matter and the coding was created
for tangible products, not services. While very
few services were involved in the home care
industry. In order to qualify for DME, The
provider need to complete lengthy and complex
checklist from insurance carriers. Home
assessment is first step in this checklist to
ensure the item will be able to perform its
purpose in a safe manner. Moreover, trained
technicians must perform the item delivery,
assembly of the equipment. There must be
available 24 hours a day seven days a week
customer service department in case of emergency
or maintenance concerns and the capability of
retrieving the item from the patient when
necessary.
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How HME Billing Differ From DME Billing?

• Your billing team verifies insurance coverage and
  all necessary documentation and communicates with
  the insurance carrier on behalf of the patient.
  This back office process takes lots of time for
  training employees, resolving claims disputes,
  challenging incorrect reimbursements on behalf of
  the patient, or discovering and correcting
  billing claims submission errors.
• If you meet the following two conditions then
  Medicare covers your durable medical equipment
  (DME)
• Your primary care provider (PCP) must sign an
  order, prescription, or certificate after a
  face-to-face office visit. In this document, your
  PCP must state that the required office visit
  occurred, that you need the requested DME to help
  a medical condition or injury, and that the
  equipment is for home use.
• Your face-to-face office visit must take place no
  more than six months before the prescription is
  written.
• Once you have your PCPs order or prescription,
  you must take it to the right supplier to get
  coverage. Be sure only to use suppliers with
  approval from Original Medicare or your Medicare
  Advantage Plan.
• HME Billing
• HME refers to medical equipment that is
  appropriate for a home environment and can be
  managed by a patient or non-professional
  caregiver. When it comes to HME billing compared
  with DME, you need put extra efforts for
  establishing an internal communication to meet
  patient needs, complete surveys, and attain
  accreditation and FDA licensure for oxygen.
  Moreover, there is a possibilities of
  state-specific regulations which needs licensure
  or certifications.

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How HME Billing Differ From DME Billing?
HME services are gaining traction day by day
include physical therapists, dieticians, in-home
visits from nurses ,diabetic counselors, and
respiratory therapists. This services makes
billing process more complex as it requires
extensive training and experience from billing
experts. In conclusion, DME billing covers
equipment where HME billing covers the
cooperative effort for management of the use of
the equipment and patient care within the home.
However due to complex billing structure of DME
and HME billing organizations are increasingly
relying upon outsourcing better allocate its
resources. We are medical billing expert and
handle your DME and HME billing for reimbursement.
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