3 Most Common DME Billing Challenges

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INFO HUB SERVICES 3 Most Common DME Billing
Challenges
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Introduction DME billing is complex, and Info
Hub, a leading offshore DME billing company in
India comes with the required expertise to help
increase your revenue. Efficiency is the key to
success in any healthcare setting! Your ability
to innovate and improve patient experience while
lowering costs and minimizing mistakes is
critical to your success. To fulfil these
objectives, it is critical to have a
well-functioning medical billing system in place.
With our DME billing services, we leverage our
experience, expertise, and latest technology to
ensure complete accuracy and competence.
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Policy Violations

• When invoicing or payment for services is not in
  accordance with the written policy, it is
  considered a policy violation.
• DME claims sent to Medicaid rather than Medicare
  or another primary insurance plan. Medicaid is
  considered the payer of last resort, so payment
  should be sought from other insurance first.

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• Coding Errors

• Errors in code are another major cause. The claim
  will be refused if your billing team submits
  medical documentation with different codes than
  the ones billed. Typical coding related
  challenges are
• Using HCPCS codes incorrectly to drive a
  diagnostic related group (DRG)
• For trauma and fracture diagnosis codes, the
  seventh character is incorrectly applied
• Respiratory failure is misdiagnosed
• Using guidance tools incorrectly
• Inadequate documentation of devices, components,
  grafting materials, etc

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• Insufficient Documentation
• When a providers documentation does not fully
  support the billed procedure code, it comes under
  the insufficient documentation error. Common DME
  claim documentation errors include
• Medical Necessity It is critical that the
  evidence demonstrates the treatments billed were
  medically necessary under Medicares coverage and
  payment policies.
• Use of Modifiers Incorrectly employed modifiers
  for DME billing can result in claims being denied
  or rejected. Even a misplaced code can result in
  a claim denial.
• Verification of Patient Data  A common factor is
  a lack of patient data verification. Claims are
  denied by the CMS or the insurance provider if
  there are minor errors in names, or the way forms
  are filled out.

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Ways to Reduce DME Billing Errors

• Quality control on services
• Verify the equipment or supplies provided are in
  accordance with documented policy.
• Verify the delivery of equipment or supplies is
  in line with beneficiary or representative
  signature.
• Verify that the completion of environmental
  modification is completed with beneficiary or
  representative signature

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• Quality control on beneficiary records
• Confirm if beneficiary has other insurance as a
  major payer
• Determine a beneficiary identifier on each
  document.
• Double-check the documentation accurately so it
  reflects the type of DME and quantity delivered.
• Check the quantity of units billed as part of the
  claims processing quality control.
• Confirm the procedure or service code is correct,
  along with the service dates entered on the
  documentation.
• Ensure the claims number of units and product
  description match the documentations number of
  units and product description.

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• Conclusion
• Offshore DME billing services have the required
  resources at disposal and are responsible for a
  knock in profits if they use incorrectly coded
  modifiers.
• Given the difficulties and complexities of DME
  billing, many providers opt for offshore DME
  billing companies.
• By offshoring their billing, they gain access to
  a team of highly trained coders and billers that
  are dedicated to delivering timely payments,
  minimized errors and increased collections.

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• About us
• Info Hub Services was founded in 2010, and is
  now one of the leading service providers of
  highly motivated, certified coders, and billers
  in the US medical billing industry.
• Contact Us
• India Address
• Info Hub,
• Sf No 558/2, Udayampalyam Rd, Nava India,
• Coimbatore, Tamil Nadu 641028
• US AddressInfo Hub,1280, Patterson Ter,Lake
  Mary.Florida 32747