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Showing posts with the label Healthcare Common Procedure Coding System

Medical Billing Operations for Multi-Location Practices: Streamline Workflow and Maximize Revenue

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 Managing medical billing operations for multi-location practices isn't just about submitting claims — it's about maintaining consistent performance, accuracy, and compliance across geographically dispersed sites. As practices expand, many find themselves struggling with fragmented billing workflows, data silos, and higher denial rates. The key to financial success lies in standardization, centralization, and technology integration . Why Multi-Location Practices Are Vulnerable to Revenue Loss As healthcare groups grow and open new facilities, they often inherit different workflows, staff training levels, and billing systems. Without a unified approach, these inconsistencies create bottlenecks and leak revenue at multiple stages: Claims may be delayed or submitted incorrectly. Follow-up on denials is inconsistent across offices. Staff may lack visibility into real-time performance metrics. Lack of accountability makes it hard to track root causes of billing iss...

How to order DMEPOS items correctly?

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According to the Medicare Program Integrity Manual, Chapter 5 (Items and Administrations Having Special DME Survey Considerations), before you dispense any DMEPOS item to a beneficiary, you need to have an order from the treating physician . Please note that this article is proposed for providers billing Durable Medical Equipment (DME) MACs for Durable Medical Equipment Prosthetics, Orthotics Supplies (DMEPOS) gave to Medicare beneficiaries.  Verbal or preliminary written orders: Providers may dispense most items of DMEPOS based on a verbal order or a preliminary written order from the treating physician/practitioner.  Detailed written orders needed before claim submission: A detailed written order may be a photocopy, facsimile image, electronic, or pen-and-ink original document. For all items, the provider shall have a detailed written order prior to presenting a claim.  It needs to have a description of the item to incorporate all options or additional features that wi...