DME Billing Services

Dealing with increased claim denial rates, complicated HCPCS coding, and ever-changing Medicare regulations consumes much time and revenue for DME providers focused on the necessary patient care. Streamlined DME billing services resolve these critical bottlenecks by ensuring precise coding, airtight documentation, proactive payer follow-ups, stable cash flow, and low-stress audits. Trusted DME billing specialists reduce administrative load, enhance reimbursements, and maintain compliance throughout the revenue cycle. Contact our specialists and find out how tailored DME billing solutions can sharpen operational efficiency and reinforce your business finances while optimizing your claim submission process.

DME Billing Services We Offer

Data Capturing and Verification

We collect pertinent patient demographics, insurance, and provider information. Our billing specialists safeguard CMNs and DWOs to fulfill the relevant payer regulations, preventing unnecessary denials.

Eligibility Verification and Prior Authorizations

We confirm eligibility and benefits verification before equipment delivery. Our team obtains prior authorizations and handles referrals to avoid costly time delays and denials.

Accurate Claim Preparations and Coding

We have qualified personnel who ensure the right HCPCS and ICD-10 codes are appropriate to the claim with required modifiers. We arrange claims documents as per the carrier specifications.

Claim Submission and Filing

Through our rigorous quality assurance, we receive, prepare, and submit complete and accurate claims in the appropriate payer format, ensuring faster adjudication.

Appeals and Denial Management

We conduct a thorough investigation to identify the root cause and resubmit claims with proper documentation and timely appeals on your behalf to ensure adequate and timely appeals.

Posting Payments and Reconciling

We post incoming payments with remittance advice and adjustments with precise accuracy by matching Claims with EOBs, discrepancies are reported, and variances are flagged.

Fee Schedule Management

We collaborate with your payers to establish, modify, and negotiate fee schedules to ensure your equipment and services are compensated appropriately according to prevailing rates.

Custom Reports & Practice Statements

Achieve complete transparency with your revenue cycle and receive detailed custom reports and clear practice statements. We provide your reports and statements at your desired frequency to keep you updated and in control.

What Sets Us Apart from Other DME Medical Billing Companies?

As a durable medical equipment practitioner, you deserve more than simplistic billing. Our proven solutions resolve time and money inefficiencies while eliminating compliance risks.

Zero-Tolerance for Documentation Errors

We resolve gaps in CMNs, DWOs, and patient files through collaboration with your team, cutting DME claim denials at the source.

Faster Time-Sensitive Delivery Authorizations

We have a dedicated team for pre-authorization who expedite approval for necessary equipment, allowing timely, risk-free payments for device delivery.

Claims Submission Based on Individual Carrier Specifications

We do more than submit claims. We file each claim to meet specific carrier requirements, significantly reducing back-and-forth processing delays and rejections.

Improved Margins Due to Fee Schedule Optimization

Our billing specialists defend your margins by regularly negotiating and updating fee schedules, protecting your margins against annual shifts in costs and reductions from the payers.

Built-In Payment Integrity Loss Prevention

There is never the risk of underpayment with the built-in payment integrity loss prevention, which ensures that all EOBs are reconciled against their claims and your internal records.

Transparent, Actionable Billing Insights

Gain control over your DME operation with our automated denial trend, payer performance, and revenue gap reports alongside customized financial and operational reports.

Industries We Serve

Home Medical Equipment (HME) Providers
Durable Medical Equipment (DME) Suppliers
Orthotics & Prosthetics Clinics

Rehabilitation Centers
Long-Term Care Facilities
Hospice & Palliative Care Providers

Respiratory Therapy Providers
Sleep Centers (CPAP/BiPAP providers)
Mobility Equipment Vendors (wheelchairs, walkers, scooters)

Diabetic Supply Companies
Pharmacy Chains Offering DME Supplies
Ambulatory Surgical Centers (ASCs) with DME dispensing
Physician Practices Providing DME to Patients

Revolutionizing Healthcare Financials: Success Stories in Streamlined Medical Billing and Operational Transformation

Deployed Medical Billing Solutions to Combat Lengthy Claims Cycles and Transform Staff Productivity at Specialty Pharm in USA

Leveraged Cutting-edge Medical Billing Process to Improve Financial Data Management for Florida-based Medical Group

Deployed Teams to Handle End-to-end Back Office Tasks for California-based Health Insurance Company to Reap an Operational Advantage

FAQs

What DME billing equipment do you manage?

We manage billing for all DME supplies, such as wheelchairs, walkers, hospital beds, CPAP and BiPAP machines, other respiratory therapy equipment, prosthetics, orthotics, and other mobility aids.

Do you help with Medical Certificates of Necessity, DWOs, and other medical documents?

Yes, as part of our processes, we obtain and ensure all Certificates of Medical Necessity (CMN), Detailed Written Orders (DWOs), and supporting documents are collected, verified, and compliant with specific guidelines set forth by the payer.

What processes are in place to check insurance eligibility and secure prior authorizations?

Our staff verifies each patient’s insurance eligibility and benefits and obtains prior authorization and referral if required before equipment delivery to minimize claim denials.

What do you do in case of a claim denial while billing for durable medical equipment?

We figure out the reason for denial, make the needed changes, and submit timely, well-supported appeals to the claim to obtain reimbursement owed to you.

Do you post payments, and do you reconcile accounts?

Yes, we maintain accurate payment posting, explain the benefits (EOBs), claim matching, record reconciliation, and investigate discrepancies, ensuring all records are correct and complete.

How do you manage the fee schedule?

We work with the payers to establish, market, and manage your fee schedule so that the reimbursement rates are current and commensurate with other market rates.

Can you produce specific reports for my practice?

Yes, we provide customizable reports that enable tracking claims, denial patterns, cash flow, and more.

Do you provide HIPAA-compliant services?

Yes, we are bound by HIPAA regulations. All workflows, including data collection and communication, fully comply with HIPAA regulations, ensuring patient and practice privacy.

Do you work with my EHR or billing software?

We can accommodate both EHR and practice management systems. We integrate with most of the leading systems, thus ensuring smooth data transfer and minimal disruption to your workflows.

What are the steps to access your DME billing services?

Reach out to the team and share your needs. We’ll provide a tailored proposal, walk you through onboarding, and manage the transition with minimal downtime.

End-to-End DME Billing for Faster Reimbursements