We always check the insurance plan of every patient to make sure that our DMER is covered by the insurance company, particularly for those expensive items like oxygen concentrators, wheelchairs, and CPAP machines that require pre-authorization so that we do not get stuck waiting for reimbursement from the insurance company.
Our certified coders have extensive knowledge of DME-specific HCPCS codes and modifiers for products such as orthotics, prosthetics, and mobility equipment. We also navigate and facilitate complex documentation specifications to satisfy payer requirements.
We make claims on DME separately to make sure that each item is charged accurately as per the payer’s rules. We also monitor claims in real time and identify such challenges as bundling errors or missing documentation that may lead to denial of payment for expensive DME.
Our team focuses on addressing denials in the category of DME that may include exempted medical necessity, improper modifier codes, or incorrect documentation. These problems are promptly addressed and rectified to enable early resubmission and subsequent reimbursement.
We have a system for the collection and billing of patients for their DME, their co-payments, deductibles, and other out-of-pocket expenses such as diabetic supplies and home care equipment. Our method makes it easy for patients to understand their responsibilities as well as provides sound approaches to collecting data.
We are constantly updated on the current CMS guidelines, Medicare rules, and other state standards on DME billing. This includes following the rules governing competitive bidding and keeping adequate paperwork to facilitate audits.
Leverage our knowledge of Connecticut’s payer systems and regulations to maximize reimbursement and minimize billing issues in the locale.
Individual billing formats for every DME product help avert claim denial for mobility equipment or respiratory equipment.
Ongoing internal assessments for compliance and documentation reviews help maintain billing practices that are always audit-ready and protected from Medicare recoupments and penalties.
The real-time claims dashboard gives you complete visibility on the status of your claims and enables you to monitor the status, identify whether there are potential issues that may arise, and ensure you are informed.
Appropriate handling of denied claims in relation to high-ticket items such as power mobility and prosthetic devices to increase revenue realization.
Effective and sensitive patient billing communication enhances understanding and reimbursement on co-pay and out-of-pocket expenses, enhancing patient satisfaction and thus payments.
Affordable and adaptable payment models that remain an active source of assistance in the course of new products added on the menu or more patient inflow.
This category covers wheelchairs, scooters, walkers, and other mobility aids that enable the user to regain or maintain mobility and function independently.
This includes breathing support equipment like CPAP machines, oxygen concentrators, nebulizers, and others.
Refers mostly to fabricated braces, artificial limbs, and other appliances used in supporting or replacing anatomical structures to promote improved locomotion.
Includes hospital beds, lift chairs, and patient monitoring systems that provide comfort and security for patients who are receiving care at home.
This refers to equipment such as blood glucose monitors and insulin pumps, among others, which are useful in managing diabetes and keeping blood sugar levels constant.
It includes items used to manage incontinence, wound care products, as well as accessories that are meant to be used for an extended period and for essential everyday health requirements.
It involves therapeutic appliances, fitness equipment, and other related equipment used in physical therapy and treatment with the aim of helping the body recover and improve.
Provides pediatric wheelchair feeding devices and oxygen equipment designed for children who have different and distinct needs from their adult counterparts.