What Are The Most Common Reasons For Revenue Leakage In DME Billing Services_ And How To Avoid It?

Dec 23, 2020 9:44 AM ET

iCrowdNewswire   Dec 23, 2020  4:44 AM ET

It’s been the major cause of the stress for physicians who use durable medical equipment for the cure of their patients that they can’t successfully collect maximum reimbursements. Even, revenue losses/leakage is concerned with the overall healthcare community. Since there’s always been a difference between the amount your mention in a medical claim and the amount you receive as a reimbursement.

Especially, it’s always been the case for DME billing services. It always requires greater attention to prepare accurate documentation to justify the use of durable medical equipment.

Moreover, there are several complications that are involved in DME related medical services. Collectively, these complexities lead physicians to face an excessive number of claim denials and rejections. Ultimately, the claim denials cause revenue loss and impact your practice’s growth negatively.

In this article, I have mentioned detailed information about the reasons for revenue loss in DME billing services. Here are the most common reasons for the revenue loss while delivering medical care services with durable medical equipment.

1. Claim Denials:

According to recent research, “claim denials” are the major cause of 20% of revenue loss in the healthcare sector. Following are the factors that cause claim denials;

  • When medical billers mention incorrect demographic information about the patients in medical claims then an insurance company doesn’t verify those claims. As a result, due to the mistakes in documentation; a healthcare insurance company denies that claim and refuses to reimburse your hard-earned services.
  • If the medical coders have mentioned incorrect information about the physician’s services, the patient’s medical condition, and the medical necessity of the services provided by a physician then it also reduces the worth of any claim denial.
  • Also, if medical coders do not make mistakes with the information. But this time, they have used incorrect medical codes, modifiers or they have missed PIN or NPI while preparing medical claims then it also causes a claim to end up in the form of denial or rejection.
  • If medical billers/coders have submitted duplicated medical claims or they haven’t mentioned the right information about the medical services provided by the physician.

In order to avoid these problems, practitioners need to make rectifications with the medical billing system. Innovative solutions for DME billing services can allow physicians to streamline their revenue cycle management services.

For instance, the best solution that can streamline healthcare RCM is to outsource medical billing services. In this way, practitioners can collaborate with medical billing experts, so they can closely monitor your business operations to drive better results.

2. Incorrect Medical Codes:

Another common reason for claim denials is the use of incorrect medical codes for accessories and equipment. A healthcare insurance company only becomes willing to pay for any DME when the medical billing professionals identify the right HCPCS level II to submit a medical claim.

Professional medical billers can help you proceed with prior authorization of the patient’s information accurately. In this way, you’ll never miss out a chance to charge your patients accurately.

3. Non-Compliance:

It is the primary responsibility of every healthcare practice to comply with the guidelines provided by the Health Insurance Portability and Accountability Act (HIPAA) and the Office Of The Inspector General (OIG). In this way, they can meet the requirements of the legislative bodies and deliver accurate patient care services.

Although, it’s a difficult task for physicians to learn and stay up-to-date with their requirements. Because they are already highly engaged in struggling to meet the demand for increased patient flow. Especially, after the global outbreak of COVID-19, the healthcare community is dealing with a shortage of resources. Hence, encouraging other patients to take self-care with DME has become a need of the hour.

For this purpose, practitioners are also feeling it difficult to constantly upgrade their system according to the upcoming changes in the federal and payer guidelines. In such a case, it’s the most reliable solution to hire a DME billing company to supervise your revenue cycle management.

A professional billing company provides a complete suite of DME billing services so they are responsible to manage medical coding, compliance issues and collect reimbursement for every service you deliver.

4. Failure To Monitor:

Certainly, there is no substitute for accurate medical coding and medical claim process. If you don’t have access to these two_ then surely it can cause a discrepancy in your data. Without insightful analytics and real-time data, its impossible for physicians to track down whether they are getting paid right or not.

To take out the guesswork, physicians can consult with a reliable team that can provide the right solution for DME billing services. Since many professional medical billing companies guarantee to follow up on every medical claim until they collect their reimbursement. Hence, there will be no chance that you may fail to leave your income uncollected.

Ultimately, it’ll reduce the influx of revenue leakage and you’ll become better able to collect maximum revenue.

Medcare MSO is the name of the nation’s most trusted medical billing company in the United States. We’ve always supported physicians so they can successfully reimburse their durable medical equipment services and keep their practice running smoothly.