The DME billing situation is getting worse. Much of the uncertainty around Durable Medical Equipment (DME), also known as Home Medical Equipment (HME) is caused by the typical way that the healthcare industry and the insurance companies look at it. Most insurance providers do not include several DMEs in the list of mandatory medical requirements. Although not all are covered within insurance policies. Even Medicare and Medicaid have not certified some of these DMEs, making things worse. The usual classifications are:

♦ Standard DME: One that adequately meets the patient’s medical needs of the patient and is not specifically designed or customized for an individual’s use.
♦ Nonstandard DME: One with features that may be deemed as a luxury or an enhancement of a basic equipment considered as a convenience feature.

The doctors are the most affected by such restrictions. Even while prescribing an enlisted DME, they have to keep track of the permissible reimbursement level for the DME in the patient’s policy and also support the recommendation with elaborate explanations and documentation.

According to experts, pharmacies selling Durable Medical Equipment (DME) products should do the following to deal with the growing DME billing issues:

♦ Procure software service to handle HME billing and documentation.

♦ Get educated on the medical insurance laws regarding DMEs. Regularly reference the DMEMAC websites for information on coverage policies, Local Coverage Determinations (LCDs), Supplier Manual, and more.
♦ Enlist the help of professional service providers to manage their DME billing process.

DME sellers in general (pharmacies, hospitals, or other healthcare providers) often make the mistake of considering DME billing equivalent to general pharmacy billing. In reality, DME billing is much more complex, especially with the rental bills. Some of the common issues relating to rental billing can be covered through electronic claims solutions that can bill payers including the government and the private ones. However, it is not as easy it sounds. Most pharmacies are run by in-house staffs that neither have time or expertise to categorically deal with each DME product. The inability of the DME sellers to provide regular training to their staff or recruit professional billers and coders in their payroll, keeps the problem at the status-quo. This is where professional DME billing services like Sun Knowledge can make the difference.

How Sunknowledge Addresses Your DME Billing Challenges

Sunknowledge Services Inc. started its journey in 2007 and is one of the best DME billing handlers today. We provide you dedicated managers who are the best DME billers in the industry. Our approach to address your DME billing woes is straightforward:

♦ We take care of your daily claims submissions and establish a proper follow-up process. This process increases the reimbursement rate and reduces the turnaround time of each claim.

♦ We provide on-site training and toolkits when required.

♦We a state-of-the-art technology platform that is efficient and error-free. Our platform transforms your practice’s DME billing process into a seamless one.

Simplicity and commitment are the two pillars of our foundation. Customized reports and regular updates will keep you in the loop and ensure a totally transparent process transparent. We are the ONLY medical billing company to provide HISCOX insurance coverage for clients up to $1 million for any error of omissions that we make!! Working with us transforms your process so that it is a 100% compliant HIPAA environment. We offer the lowest of fees in the industry and with no hidden cost in the contract; you can expect a transparent and open partnership that will yield incredible results.