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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Credentialing For DME Companies

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Durable Medical Equipment (DME) is equipment that includes oxygen supplies, wheelchairs, iron lungs, catheters, etc. As you are starting a Durable Medical Equipment (DME) company, be prepared with time on hand, money, endurance, and determination; as it ultimately boils down to being paid for the products sold by your company. This means receiving DME bills from clients (patients/healthcare providers) and accepting the insurance, billing the insurance, and finally receiving payments for the DME billing from the insurance provider- is called Credentialing For DME Companies.

DME business also referred to as Home Medical Equipment business is replete with potholes along the way which need to be cleared. One of them is ‘Provider Credentialing.’ Credentialing simply denotes verification. It’s also known as DME credentialing, DME medical credentialing, DME provider enrollment, insurance credentialing, or getting on insurance panels. These terms imply that the patient is going to pay through insurance and your company is “In-Network” with the insurance companies. And, as you go on to be accepted as a provider (post credentialing), receiving payments of DME billing through this process is known as an “In-Network” provider. It also implies acknowledging more clients along with on-time and accurate payments. There are a number of companies through which a DME company can/should be credentialed; government organizations like Medicare, Medicaid, or Tricare, and other big players (commercial insurance) in the market such as Aetna, BCBS, UHC, Cigna, etc. Smaller companies could be targeted too as they have immense potential with respect to a greater number of clients and comprise lesser competition.

To know more about Credentialing For DME Companies, click here: https://bit.ly/3oeJpNS Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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