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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Know your DME HCPCS Codes

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In DME medical billing, your DME coders require correct HCPCS codes and correct modifiers for providing more details about the equipment. If your medical coders cannot use modifiers or not correctly use them, then the insurance company may deny the claims. Some common DME modifiers include RR- rental, UE- purchase of used equipment, and NU- purchase of new equipment. Know your DME HCPCS Codes

When a laboratory demand, request for DME is being filled, medical coders will be needed for ICD-10 codes for a patient’s diagnosis.

To use an appropriate HCPCS code for the DME item, many HCPCS codes need a modifier. Modifiers are used to provide more details about the DME item. e.g. The modifier might indicate to HMSA that an item is new, rented on a capped basis, or rented. For capped rentals, modifiers differentiate which month’s rental is being billed.

If your billers misuse these modifiers then the claim will be rejected. To speed up this process of your claims, show the first-month rental by adding the appropriate modifier code and bill your claims in successive order.

Outsource DME Billing Services to MedicalBillersandCoders – The Leader in Medical Billing & Coding

HCPCS Code Range:

E0100-E8002: Durable Medical Equipment

E0100-E0159: Walking Aids and Attachments

E0160-E0162: Sitz Bath/Equipment

E0163-E0175: Commode Chair and Supplies

E0181-E0199: Pressure Mattresses, Pads, and Other Supplies

E0200-E0239: Heat, Cold, and Light Therapies

E0240-E0249: Bathing Supplies

E0250-E0373: Hospital Beds and Associated Supplies

E0424-E0487: Oxygen Delivery Systems and Related Supplies

E0500-E0500: Intermittent Positive Pressure Breathing Devices

To learn more about Know your DME HCPCS Codes, click here: https://bit.ly/3rLoDUp Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

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