Complete DME Billing Process Explained. - PowerPoint PPT Presentation

dme an abbreviation for durable medical equipment n.
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Complete DME Billing Process Explained.

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  1. DME, an abbreviation for Durable Medical Equipment. Meant to provide assistance in daily life activities like walking, breathing, etc. There is a separate equipment for separate kinds of physical conditions. Some examples are: CPAP, TENS, Wheelchair, Crutches, Canes, Walkers, and Commodes, etc.

  2. DME Billing means billing for the payment of DME items by a medical provider. This is usually done by medical providers or their in-house staff. Billing for DME is an inclusive step in the Revenue Cycle Management process. Includes various steps that need to be executed carefully for maximum profit earnings.

  3. The very first step in an RCM cycle is patient registration. Includes collecting information regarding patient condition, treatment history etc. Appointment with the doctor is scheduled and other demographics information is gathered. Insurance details are captured and ABN, COB & AOB documents are signed by the patient.

  4. Entire patient and provider episode is recorded in an audio format. This audio file is sent to a medical transcription team for conversion. Audio file is converted into a readable format and this file is sent to CPCs. Certified Professional Coders (CPCs) assign codes based over the received file.

  5. These codes are forwarded to an in-house or outsourced medical billingteam. Necessary documents like office notes, progress notes, Prescription or RX, etc. are sent. The billing team organizes all the information in a medical billing claim form. The widely used claim form is CMS-1500, which is also known as HCFA.

  6. While the information is being organized and filled into claim forms, eligibility is verified. This can be verified in two ways, either electronic or via manual modes like calling the insurance lines. The TFL (Timely Filing Limit) for submission is also verified so that claims can be submitted timely. After successful verification and information filling, claims are submitted with insurance payers.

  7. Normally, insurance payers process a claim within 60 days of claim submission. Payments are received either in form of check or NEFT transfer. In cases, when there is a denial or payment is not to be made, they send rejection letters to providers. These claims are followed up by a Denials handling team that rectifies errors and submit the claims for re-processing.

  8. Bikham Healthcare is a unit of Bikham Information Technology, specializing in medical billing and accounting services. Has a full-fledged unit of expert medical billers and coders who are highly experienced and knowledgeable. Services are carried out in full compliance to HIPAA standards and information security protocols. More than over 14 years of unmatched expertise and experience in offering profitable medical billing solutions.

  9. US Office 99 Wall Street #158, New York NY 10005 Finance & Accounting :  +1 800-935-0865 General Queries: info@bikham.com Health Care: healthcare@bikham.com`