Medical Billers and Coders

  Improper Payment Reasons Durable Medical Equipment (DME) suppliers of surgical dressings and physicians submit claims for surgical dressings and CMS covers it under the surgical dressings benefit i.e., SSA Section 1861[s][5]. CMS recently published Medicare Fee-for-Service (FFS) improper Medicare payments rate for surgical dressings for the 2020 reporting period. For this reporting period, the improper payment rate for surgical dressings was 67.3 percent, with a projected improper payment amount of over $194.9 million. For the 2020 reporting period, insufficient documentation accounted for 82.4 percent of improper Medicare payments for surgical dressings. Additional types of errors for surgical dressings in the 2020 reporting period were no documentation (1.9 percent), medical necessity (1.7 percent), incorrect coding (1.9 percent), and other (12.2 percent).  Avoiding Improper Medicare Payments All claims billed to Medicare require a written order or prescription from the treati

  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-m

  All healthcare providers are searching for a streamlined DME billing operation team that may handle their DME billing process without much hassle. According to MarketWatch, the worldwide marketplace for Durable Medical Equipment (DME) is predicted to achieve up to USD 246.6 billion by the year 2026. This rise is predicted because of the advantages that DME products like a wheelchair, nebulizers, canes, crutches, walkers, etc. wear to people. Besides making patient’s life easy, DME products also help these patients live a life without much pain making them independent. Streamline your DME Billing with MBC The right process will make your DME billing and coding process all the stronger and help you get closer to your payments. Besides the above benefits, technological advancement within the DME medical equipment is additionally another reason for the increase of the DME market and in fact, the rising geriatric population. As old people are more prone to chronic diseases and require

The Medicare program just pays for health care services that are medically necessary. In figuring out what services are medically necessary, Medicare primarily depends on the expert judgment of the recipient's treating physician, since the person knows the patient's set of experiences and settles on basic choices, for example, conceding the patient to the hospital; requesting tests, medications, and therapies, and deciding the length of therapy. At the end of the day, the physician has a vital part in deciding both the medical requirement for and use of, numerous health care services, including those outfitted and charged by different suppliers and providers.  Physicians are needed to confirm the medical necessity for any help for which they submit bills to the Medicare program. Physicians are associated with authenticating the medical necessity when requesting services or supplies that should be charged and given by a free provider or supplier. Medicare expects physicians to