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Top Common Revenue Leakage Reasons in DME Billing Services

by | September 22, 2022 | 12:55 pm
Category : DME
Revenue Leakage Reasons in DME Billing

Durable medical equipment (DME) providers often wait for service reimbursement, affecting the revenue cycle. Several factors affect the revenue collection process: calculations, documentation, manual errors, and other delays in filing claims, among others. Considering low reimbursements, attrition, and other industry factors, DMEs must focus on improving the DME billing process.

Increased efficiency will help stop revenue leakages from impacting business operations, and your business will grow in the competitive market without taking huge losses. For an immediate solution, you can contact the DME billing company, and they can manage DME billing operations and increase revenue collection. Here are the most common revenue leakages in medical billing organizations.

revenue leakage reasons

Lack of attention and Guidance

Incorrect information entered at admission can create many issues when filling and processing patient requests and claims.

While prescription processing and billing are handled by a dedicated and trained DME billing partner, providing necessary training to staff to help patients fill in the accurate information is often outside the DME provider’s purview. Therefore, it becomes even more critical that in-house staff dedicates their time to gathering missing intake documents and focusing on patient care. This will also help streamline productivity and set up a process for better results.

Documentation Errors: Incomplete or inaccurate information about patients’ clinical and medical history and insurance coverages can impact your revenue. The insurance company won’t process the full reimbursement in such a scenario. Thus, giving internal staff the time and opportunity to focus on gathering missing documents from referring doctors becomes essential to the continuity of operations.

Tips – Review patient information, clinical documents, sales order, and insurance eligibility.

  • Avoid mismatch of information and overwriting.
  • Recheck the dates and ensure numerical accuracy
  • Create accurate sale orders
  • Transparent reporting and scheduling
  • Monitor intake and filing process

Claim Denial

Insurance companies can deny claims for tiny mistakes. Some common reasons for denials are improper documentation, inaccurate patient data, and partial insurance. Insurance companies always look for accurate information and the date of filing the claim; specific claims should be filled on given dates to process the applications. A dedicated DME billing partner will review your claims documentation before sending them for approval to decrease denial rates.

Denial Management: A DME medical billing partner will take immediate action on denied claims and review the application twice before resubmission to improve the chances of approval.

Tip: Avoid duplication of claim

  • A DME medical billing partner will check adjustment services and claim
  • A DME medical billing partner will review the claim limitations
  • A DME medical billing partner will make sure that quality control (QC) steps are implemented to minimize technical and human errors in the forms

Coding Errors

A DME medical billing partner will identify the correct medical codes and enter them accurately into documents to help the insurance company process claims fasters. This process can eliminate doubt or concern and translate physician reports into alphanumeric codes. The healthcare industry follows this trend to summarize medical information, and it becomes essential for you to file claims in accordance with insurance company guidelines.

Solution

Outsourcing firms provide strategic solutions to your business to help you get your work done faster. Outsourcing firms can access experienced resources and revenue cycle specialists to manage your DME billing services, leverage business operations, and increase revenue. Based on your requirements, you can choose to add expertise to your team.

We help our DME clients with end-to-end medical billing solutions to increase their collections. Our services include healthcare revenue cycle management, key performance indicators, patient scheduling solutions, patient appointment management, claim management, denial management, and insurance eligibility verification. We follow and stay updated with all the healthcare compliance laws such as HIPAA and the HITECH Act to ensure we maintain productivity and adhere to effective business regulations.

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