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Know about Durable Medical Equipment billing

Durable medical equipment (DME) refers to a variety of medical devices and equipments such as wheelchairs, walkers, hospital beds, diabetic supplies, home oxygen equipment etc. that can help people with disabilities or chronic health conditions. These are ordered by a healthcare provider for a patient’s routine, long-term use.

Billing for durable medical equipment is a complex and time-consuming process. Regulation changes and audits are common within the DME industry. A strict billing procedure right from the intake process is required to maintain a healthy cash flow. DME is typically covered by original medicare and for that, these supplies and devices must meet specific criteria. The durable medical equipment must be proved medically necessary and able to withstand repeated, long-term use within a home.

The categories of DME include:

Mobility Aids

Personal Care Aids

Prosthetic Limbs


Oxygen Equipment

Billing of DME claims

DME Revenue Cycle Management demands keeping up to date with the changes in reimbursement and coding guidelines. The documentation needs to be carefully done and every detail have to be monitored since any incorrect information can lead to higher chances of claim denials and revenue loss. For an effective DME billing process and accurate reimbursement, healthcare providers have a lot to watch out for, so that they don’t lose both time and money.

Verify insurance information of the patient when placing the order.

Gather all documents such as prescriptions, prior authorization, certificate of medical necessity etc. for the claim.

Verify that all claim information is correct.

Submit the claim using the appropriate documentation and to the correct insurer.

Durable Medical Equipment Coding

The DME billing is a complicated process as compared to the other specialty billing. The DME coding falls under HCPCS Level II. The coding should be done perfectly, and the entities must be clearly and precisely defined.

Once the doctor confirms the requirement of any DME for a patient’s medical condition, the necessary documents must be made for claim submission.

The patient needs to reach out to a DME supplier. The coder will have to verify the prescription and collect the patient’s insurance details.

Upon finishing the necessary paperwork, the equipment is handed over to the patient.

The medical coding is then done with appropriate codes.

The entire procedure is encrypted in the code and handed to the insurance company.

The appropriate authorization and billing process is done so that the patient receives the claim amount.

Get A Free RCM Audit For Your DME Billing and Compliance

Outsourcing Durable Medical Equipment Billing

Due to the complexity of DME billing, it can be challenging for providers to keep up with the changing billing regulations and at the same time ensure maximum reimbursements. Outsourcing DME billing is an effective solution to eliminate administrative head aches so that they can focus on patient care.

Taking DME billing services from professionals like Practolytics has the following advantages:

Skilled team

Improve processes and eliminate billing challenges with expert advice.

Customer service

Rapid responses and efficient customer care through various modes of contact.

Custom reporting

Stay focused on important performance metrics and understand how your business is doing.

One stop solution

Efficient Revenue Cycle management support at best pricing.

How can Practolytics help?

Practolytics is your one-stop solution for all the medical billing, practice management, patient management, and revenue cycle management activities a healthcare practice needs to carry out. A Platinum partner amongst 850+ billing companies, Practolytics is a 20+ year-old healthcare technology and revenue cycle management services company, providing medical billing service solutions to 180+ practices of all sizes spreading across 31 states and serving more than 28 critical specialties.

If you are looking for a trusted DME medical billing company, Practolytics with its diverse background in every aspect of healthcare is your best bet. Outsource DME billing to us, we can help you streamline your billing processes so that you can focus on your primary responsibility – patient care.

Optimize Your DME Revenue

Practolytics expertise can help you in maximizing your DME revenue.

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