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Common Errors With DME Billing Services
• One of the most scrutinized billing areas by Medicare and other
commercial carriers is the Durable Medical Equipment (DME) billing. One
of the primary reasons it is often under investigation is that DME billing
Services appear to be anything but straightforward. Furthermore, the
complexities manifolds when healthcare providers and facilities integrate
the DME billing into their service to increase revenues.
• Medicare has been known to lose more than $60 billion through faulty
billing each year, and part of the waste is due to spending on the DME
billing.
• If your practice is losing money due to the DME billing, it is certain that you
are making some errors. You are likely making one of the common errors in
the procedure.
https://www.247medicalbillingservices.com/
• 1. Patient Verification
In most cases, DME claims are denied due to wrong information or
small error provided by the CMS or the insurance provider. For example, a
slight change in the name that might look insignificant or the way a form has
been filled up is deemed wrong by the payer will lead to claim rejection or
denial.
• 2. Errors with Codes
If a document indicates a different code than that of the billed or
serviced, the insurer will reject reimbursement. Also, a claim will be rejected
or denied if the service is offered by someone else other than the billing
provider. There can be coding errors in medical billing services shown as
unbundled will get the claim denied. Also, even if the beneficiary has been
discharged to another place after the procedure is considered as error. At the
same time, the one in the coded claim is different.
https://www.247medicalbillingservices.com/
We are listing the five most common errors in DME
billing services:
• 3. Wrong Use of Modifiers
Often in DME billing, wrong modifiers or a misaligned code can reject
the claim or get denied. Hence, it is vital that when written codes are used
for the service, correct modifiers are mentioned to get the reimbursement
for the service rendered.
• 4. Necessity of the Medical Assistance
Once a medical assistance is done in DME service, the documentation
needs to prove that the billed service was necessary for the patient. If the
Medicare coverage and the insurance providers feel that medical assistance
is unnecessary, the claim will be denied or rejected.
https://www.247medicalbillingservices.com/
We are listing the five most common errors in DME
billing services:
• 5. Insufficient or Incomplete Documentation
If the medical billing documentation provided has inadequate or
insufficient support for the service provided, the payment will be rejected.
The onus is on the service providers to prove that the billed services were
provided and at par with the level billed. Any missed information like a
signature of the physician on the order or an incomplete form that does not
have the date or if each date of service it’s not built separately, then the
claim will also be denied.
Furthermore, before providing the service, the facility needs to check
the number of units that service can be delivered within a specific time to
the member. If the number of services exceeds the number allowed by the
insurance policy, the claim will be rejected.
https://www.247medicalbillingservices.com/
We are listing the five most common errors in DME
billing services:
How To Ensure There Are No Errors?
• It has been estimated in medical billing and coding services, out of the $3.2 billion that
goes to waste in the Medicare Trust Fund, $2.6 billion is due to insufficient documentation.
It is essential that proper documentation with adequate medical coding and correct
information is provided so that it does not lead to claims denial. One of the best ways to
ensure none of this happens is by outsourcing DME billing services to an efficient medical
billing company such as 24/7 Medical Billing Services.
• A team of specialized medical billers and coders ensures that all documentation, codes,
and modifiers are correct for the claims. Also, they ensure claims are submitted within the
time frame. Additionally, in case of any denials, it is appropriately followed up. Moreover,
with the constant changing in the CMS rules and regulations, DME billing staff must have
in-depth knowledge of the changes. While at a time, it is not possible, an outsourced
partner such as 24/7 Medical Billing Services will ensure that all the DME billing is done as
per the new laws and regulations. So there is no claim rejection, thus allowing you to have
a seamless cash flow and a flawless revenue management cycle for your DME services. For
more information on outsourcing the medical billing services, contact us today!
https://www.247medicalbillingservices.com/
• About 24/7 Medical Billing Services:
• 24/7 Medical Billing Services is the nation’s leading medical billing service provider catering
services to more than 42 specialties across the entire 50 states. You can rely on us for end-to-end
revenue cycle management. We guarantee up to 10-20% increase in the revenue with cost
reduction of your practice for up to 50%.
• Call us today at 888-502-0537 to know more on how we can help boost profitability for your
practice.
• Media Contact:
• 24/7 Medical Billing Services,
• Ohio:
• 28405 Osborn Road, Cleveland, OH 44140
• Georgia:
• 3001 Greenfield Drive, Marietta GA 30068
• Tel: + 1 -888-502-0537
• Email - info@247medicalbillingservices.com
https://www.247medicalbillingservices.com/

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Common Errors with DME Billing Services.pptx

  • 1.
  • 2. Common Errors With DME Billing Services • One of the most scrutinized billing areas by Medicare and other commercial carriers is the Durable Medical Equipment (DME) billing. One of the primary reasons it is often under investigation is that DME billing Services appear to be anything but straightforward. Furthermore, the complexities manifolds when healthcare providers and facilities integrate the DME billing into their service to increase revenues. • Medicare has been known to lose more than $60 billion through faulty billing each year, and part of the waste is due to spending on the DME billing. • If your practice is losing money due to the DME billing, it is certain that you are making some errors. You are likely making one of the common errors in the procedure. https://www.247medicalbillingservices.com/
  • 3. • 1. Patient Verification In most cases, DME claims are denied due to wrong information or small error provided by the CMS or the insurance provider. For example, a slight change in the name that might look insignificant or the way a form has been filled up is deemed wrong by the payer will lead to claim rejection or denial. • 2. Errors with Codes If a document indicates a different code than that of the billed or serviced, the insurer will reject reimbursement. Also, a claim will be rejected or denied if the service is offered by someone else other than the billing provider. There can be coding errors in medical billing services shown as unbundled will get the claim denied. Also, even if the beneficiary has been discharged to another place after the procedure is considered as error. At the same time, the one in the coded claim is different. https://www.247medicalbillingservices.com/ We are listing the five most common errors in DME billing services:
  • 4. • 3. Wrong Use of Modifiers Often in DME billing, wrong modifiers or a misaligned code can reject the claim or get denied. Hence, it is vital that when written codes are used for the service, correct modifiers are mentioned to get the reimbursement for the service rendered. • 4. Necessity of the Medical Assistance Once a medical assistance is done in DME service, the documentation needs to prove that the billed service was necessary for the patient. If the Medicare coverage and the insurance providers feel that medical assistance is unnecessary, the claim will be denied or rejected. https://www.247medicalbillingservices.com/ We are listing the five most common errors in DME billing services:
  • 5. • 5. Insufficient or Incomplete Documentation If the medical billing documentation provided has inadequate or insufficient support for the service provided, the payment will be rejected. The onus is on the service providers to prove that the billed services were provided and at par with the level billed. Any missed information like a signature of the physician on the order or an incomplete form that does not have the date or if each date of service it’s not built separately, then the claim will also be denied. Furthermore, before providing the service, the facility needs to check the number of units that service can be delivered within a specific time to the member. If the number of services exceeds the number allowed by the insurance policy, the claim will be rejected. https://www.247medicalbillingservices.com/ We are listing the five most common errors in DME billing services:
  • 6. How To Ensure There Are No Errors? • It has been estimated in medical billing and coding services, out of the $3.2 billion that goes to waste in the Medicare Trust Fund, $2.6 billion is due to insufficient documentation. It is essential that proper documentation with adequate medical coding and correct information is provided so that it does not lead to claims denial. One of the best ways to ensure none of this happens is by outsourcing DME billing services to an efficient medical billing company such as 24/7 Medical Billing Services. • A team of specialized medical billers and coders ensures that all documentation, codes, and modifiers are correct for the claims. Also, they ensure claims are submitted within the time frame. Additionally, in case of any denials, it is appropriately followed up. Moreover, with the constant changing in the CMS rules and regulations, DME billing staff must have in-depth knowledge of the changes. While at a time, it is not possible, an outsourced partner such as 24/7 Medical Billing Services will ensure that all the DME billing is done as per the new laws and regulations. So there is no claim rejection, thus allowing you to have a seamless cash flow and a flawless revenue management cycle for your DME services. For more information on outsourcing the medical billing services, contact us today! https://www.247medicalbillingservices.com/
  • 7. • About 24/7 Medical Billing Services: • 24/7 Medical Billing Services is the nation’s leading medical billing service provider catering services to more than 42 specialties across the entire 50 states. You can rely on us for end-to-end revenue cycle management. We guarantee up to 10-20% increase in the revenue with cost reduction of your practice for up to 50%. • Call us today at 888-502-0537 to know more on how we can help boost profitability for your practice. • Media Contact: • 24/7 Medical Billing Services, • Ohio: • 28405 Osborn Road, Cleveland, OH 44140 • Georgia: • 3001 Greenfield Drive, Marietta GA 30068 • Tel: + 1 -888-502-0537 • Email - info@247medicalbillingservices.com https://www.247medicalbillingservices.com/