DME Billing – The Scenario and The SunKnowledge Solutions

DME Billing is a very complex subject. It is very ironical that Durable medical equipment (DME) providers are mostly not short of physician orders for supplies yet they struggle to recover the expected revenue. A deep insight reveals, lack of a proper revenue oversight forces many DME providers messing up with the DME reimbursements. The basic drawback is incorrect DME billing. A mistake in the billing of just one medical device can result in a loss of thousands of dollars for a DME provider.

The primary problem in DME billing arises from the distinctive difference between billing for DMEs and billing for other clinical procedures. Unlike most clinical procedures, DMEs are mostly ancillary services and in many cases mistaken as medically unnecessary. In some cases, the prescribed DME is found beyond the permitted reimbursement level. It is also not well supported by Healthcare Common Procedure Coding System (HCPCS) making the case weaker.

The already shaken up sector has been hit again with regulatory decisions like the Final Rule. The mandate issued by CMS requires establishing a prior authorization process for some DMEs, prosthetics, orthotics, and supplies (DMEPOS). Although the main objective of the decision was to bring transparency in the overall DME billing processes by controlling prices rises and illegal practices, the Final Rule has added complications in the prior authorization process for the DME providers and thereby affecting billing and revenue generation.

Struggling with so many negatives, most DME providers seek refuge in professional medical billing services who can meet the challenges associated with DME billing like insurance approvals, HCPCS, permissible level for reimbursement, etc.

If you are one of the DME providers suffering like numerous others, you are lucky that Sunknowledge is there for you. One of the leading healthcare process operation services, Sunknowledge has a huge experience in DME billing services across the country serving for the last 10 years. Our expert billing handlers are well versed with ICD-10 and well updated with the latest regulatory requirements. We also provide a holistic solution to your practice through our revenue cycle management and/or practice management solutions. Partnering with Sunknowledge for your DME billing will save you from spending a huge amount including training costs for the in-house staff or employing specialists with high salary. This is absolutely been made possible due to our astonishingly low fees and opportunity to avail standalone services.

Here’s what you get from SunKnowledge:

♦ 80% Reduction in Billing Costs
♦ Dedicated account manager
♦ Low fee standalone services at $8 per hour
♦ 99% accuracy
♦ Increased revenue collection up to 97%
♦ Unsurpassed speed
♦ No binding contracts
♦ 100s of clients with excellent references
♦ 100% HIPAA Compliance
♦ Fully supported by Hiscox Insurance
♦ 100% client retention
♦ Daily/Weekly/Monthly customized reports
♦ Clients’ legal issues handled by Nixon Peabody
♦ Free telemedicine platform

Isn’t it great enough for your practice to make a turnaround and recoup revenue? If you think so, call us at the earliest. If you have any doubt, get in touch or simply book an online demo.



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