What Clean Claim Rate Should a Dermatology Billing Partner Actually Guarantee You?

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Choosing a dermatology billing partner based only on a promised clean claim rate can be misleading. A billing company may tell you that it maintains a 95%, 97%, or even 99% clean claim rate. But before accepting that number, you need to know how the rate is measured, what claims are included, and whether those clean claims are actually being paid correctly . For dermatology practices, this matters because a claim can pass an initial billing check and still face problems related to medical necessity, modifiers, procedure coding, payer policies, or underpayment. A clean claim rate should therefore be viewed as one part of the revenue cycle, not the entire performance picture. What Clean Claim Rate Should a Dermatology Billing Partner Guarantee? A reasonable contract target is 97% or higher , provided the billing partner clearly defines the metric and measures it consistently at the payer level. The percentage itself, however, is only part of the agreement. A dermatology practice should a...
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Benefits of Outsourcing DME Billing to Improve Your Revenue

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As any durable medical equipment (DME) provider will confess, securing reimbursements from Medicare and private insurance carriers is one of the biggest challenges of running a DME business. It’s time-consuming and labor-intensive, and for all their effort, DME providers don’t always get full reimbursements. If not paid attention, inaccurate DME billing could lead to lower revenues and, in worst-case scenarios, cause DMEs to windup their business. Outsourcing your DME billing services to reliable medical billing companies like MedicalBillersandCoders (MBC) could be a smart and efficient way to get maximum reimbursements and countless other benefits. Some of the Benefits of Outsourcing DME Billing services are listed below. 

Benefits of Outsourcing DME Billing to Improve Your Revenue

Less Billing Errors

DME billing offers a unique set of challenges. It includes coordinating with different parties and requires an understanding of the HCPCS (Healthcare Common Procedure Common System) Level II codes. Each type of DME has a unique HCPCS Level II code, and the biller is responsible for ensuring that each piece of equipment is coded correctly. For example, when submitting a claim for a continuous positive airway pressure (CPAP) machine, the biller needs to code the machine as well as the mask and tubing used with it individually.

A medical billing company that specializes in DME billing and coding knows the ins and outs of the process, so they are less likely to commit billing and coding errors that would result in denied or delayed reimbursements. The billing company will obtain all necessary documentation i.e., the patient’s billing and insurance information, pre-authorization from Medicare or insurance carrier, and certificate of Medical Necessity from the patient’s doctor, and check these for accuracy, compliance, and medical justification. Should the claim be denied, they will assess and address the reasons for denial, and resubmit the claim where possible.

To know more about How outsourcing DME Billing can improve your revenue click here: https://bit.ly/3ZSAGyl
 Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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