3 Most Common DME Billing Challenges

1. INFO HUB SERVICES 3 Most Common DME Billing Challenges Email Us : inquiry@infohubservices.com Call Us: (888) 694-8634

2. 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. • Email Us : inquiry@infohubservices.com Call Us: (888) 694-8634

3. 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. • Email Us : inquiry@infohubservices.com Call Us: (888) 694-8634

4. 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 • Email Us : inquiry@infohubservices.com Call Us: (888) 694-8634

5. Email Us : inquiry@infohubservices.com Call Us: (888) 694-8634

6. Insufficient Documentation When a provider’s 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 Medicare’s 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. • Email Us : inquiry@infohubservices.com Call Us: (888) 694-8634

7. 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

8. 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 claim’s number of units and product description match the documentation’s number of units and product description. • Email Us : inquiry@infohubservices.com Call Us: (888) 694-8634

9. 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.

10. 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 Address:Info Hub,1280, Patterson Ter,Lake Mary.Florida 32747