Medical Billers and Coders

  Durable medical equipment billing is the process by which insurance companies are charged for the services provided to their clients. And to achieve complete reimbursement dollars billing codes that represent different aspects of the DME process are implemented. In this blog, here our experts shared information on specialization Considerations for DME Suppliers in Medical Billing. The characters the biller enters relate to different aspects of a diagnosis or procedure and allow the information to be uploaded for billing without having to manually define either diagnosis or procedure. This allows the process to be implemented faster without having to describe everything in detail. When we talk about specialization consideration in DME suppliers’ one specialty that often crosses the supplier’s path is Orthopedics. Orthopedic facilities often provide patients with supplies, such as casts and canes, which are integral to patients’ treatment plans. What DME supplies can be used f...

  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 ...

  The necessity of Durable Medical Equipments (DMEs) had never been so high – in the U.S. 30% to 54% of those over 65 years have some form of disability; around 75% to 90% of such disabled require some form of DME to keep them mobile or enabled.  It is also estimated that around 1.5 million people are currently in need of wheelchairs and braces. And, when you add the population that is likely to be in need of other forms of durable medical equipment – prosthetics, orthotics, and supplies (DMEPOS) – it will be some opportunity for people involved in Durable Medical Equipment Practice Services: physicians, pharmacies, and manufacturers/suppliers. But, because DME services are physician-recommended, we are more interested in how physicians themselves can recommend, source, and administer DMEs. While physicians can benefit immensely from an integrated DME management, there are challenges on the way – being equipped with a Medicare-enrolled and recognized pharmacy, sourcing suppl...

ICD-10 and DME Billing DME billing is the process of submitting and receiving payment for a claim from the insurance company. Implementing, maintaining, and educating staff on proper billing is vital to a DME provider’s success. The challenges facing Durable Medical Equipment (DME) organizations with the upcoming ICD-10 coding system are plenty. Although the DME you bill for will still employ the same HCPCS codes, the actual difference will be in the diagnosis coding itself. Firstly, the transition from ICD-9 to the new ICD-10 coding system has led to an increase in the number of codes for procedures from 3,824 to 71,924 and simultaneously has also increased the number of codes for diagnosis from 14,025 to 69,823. Secondly, there are few one-to-one, cross-walked codes in the ICD-10 Thirdly, it is a known fact that the DME providers receive meager information from the physician to convert the codes accurately thus leading to delays in claims causing a shortage in cash flow. ...

  Long-standing concerns in DME (Durable Medical Equipment) known for unquestionable billing practices, led the government to take action for tackling fraud in the insurance industry. Medicare, the nation’s largest health insurance program, regulates the billing structure of the maximum number of healthcare providers. Due to its highly fragmented nature, Medicare is prone to widespread fraud thereby rising healthcare costs, taxes, and premiums. DME billing is  the process of submitting and receiving payment for a claim from the insurance company . Medicare pays for services given to the severely sick/disabled at home such as wheelchairs, arthritis kits, etc. But many DME companies supply cheap or bad quality equipment at good quality equipment rates to make profits or sometimes bill Medicare for equipment never provided. To crack down, on this fraud, the Centers for  Medicare & Medicaid Services  (CMS) issued new rules catering toward reducing needless consump...

  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 requ...

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 Procedur...

  Durable Medical Equipment Billing  is different from the other  medical billing  and  coding  for the specialties. Unlike the other coders and billers who work on DME need specialized training to deal with different medical situations and equipment that require different types of modifiers as requested.  DME billers need specialized in-depth, specialized knowledge of different types of HCPCS Level 2 codes. Let’s understand the procedures of coding that can be implemented to make the billing process more effective: ICD-9 codes are 3-5 digits in length and speak to the patient’s conclusion CPT restorative charging codes are in fact HCPCS Level I codes. They are 5 digits in length and speak to the methodology performed at the patient’s visit HCPCS codes are in fact HCPCS Level II codes. They incorporate the two numbers and letters and are likewise 5 digits in length. These codes speak to the majority of the provisions or gear utilized in the pati...

Durable Medical Equipment (DME) Billing   is different from the other   medical billing   and   coding   for the specialties. Unlike the other coders and billers who work on DME need specialized training to deal with different medical situations and equipment that require different types of modifiers as requested.  DME billers need specialized in-depth, specialized knowledge of different types of HCPCS Level 2 codes. Let’s understand the procedures of coding that can be implemented to make the billing process more effective: ICD-9 codes are 3-5 digits in length and speak to the patient’s conclusion CPT restorative charging codes are in fact HCPCS Level I codes. They are 5 digits in length and speak to the methodology performed at the patient’s visit HCPCS codes are in fact HCPCS Level II codes. They incorporate the two numbers and letters and are likewise 5 digits in length. These codes speak to the majority of the provisions or gear utilized in the patient...

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 for people. except from making patient’s life easy, the DME products also help these patients live a life without much pain making them independent. 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, requiring extended care that involves more of the DME products for leaving a simple life. As per the report, the worldwide DME market is ...

Equipment that gives therapeutic advantages to a patient and is basically for the long haul and home use is named Durable Medical Equipment (DME) . Because of a wide assortment of models for DME, Places for Medicare and Medicaid Administrations (CMS) established the Healthcare Common Procedure Coding System (HCPCS) and modifiers which relate to the boundaries policy and LCD and make the HCPCS code legitimate before claim processing. Modifiers are divided into several categories : Routinely purchased Pricing Modifiers: NU Purchase of New DME RR Rented DME UE Purchase of Used DME NR New when rented Capped Rental Items and modifiers: One can utilize RR in this classification with the exception of wheelchairs where the patient is permitted the choice to get one. Others are: BR The receiver has elected to rent BP The receiver has elected to purchase BU Rent or purchase not selected past 30 days despite a notification KH Purchase or First rental month KI Second and third rental months KJ Fou...

Durable Medical Equipment (DME) as a healthcare industry field is not the same as other strengths and so are its medical billing and coding requirements. You need a top to bottom and concentrated knowledge of all the refreshed HCPCS Level II codes as DME claims are ordered under HCPCS Level II.  And as to talk about DME providers, the intricate idea of reimbursement is another test they continually face. Since patients can lease costly equipment rather than buy, DME billers and coders should be aware of precisely how to code claims and when to send them to get the exact reimbursement sums. This means the code should set out the equipment that was leased and not bought. The rental period ought to be recorded independently on the case with the goal that the insurance company will pay a little reimbursement for every one of those days.  Outsourcing your DME medical billing tasks facilitates a keen answer for your hospital billing requirements , helping you to put together the wh...