Five Key Guidelines to Modify Your HME Billing Process

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HME billing

While smart solutions are required at every level of any healthcare organization, billing plays a significant role in it. So, let’s go over the billing fundamentals that are essential to growing a successful business. HME billing and DME billing are the two major forms of billing for medical equipment suppliers. Now the question is:

What do you mean by HME billing and DME billing?

The full form of HME is Home Medical Equipment. It is the medical equipment that is suitable for use at home and can be used by the patient or a non-professional caregiver. HME billing starts with referrals from hospitals, clinics, and doctors and extends across the sales cycle.

Home Medical Equipment (HME) list:

  • Air ionizer
  • Air purifier
  • Apnea monitor
  • Artificial limb
  • Bedpan

Any durable medical equipment (DME) that offers therapeutic benefits to a patient with some medical conditions is referred to as DME.

Durable Medical Equipment (DME) list:

  • Oxygen tanks
  • walkers
  • blood sugar monitors

HME vs. DME: what’s the difference?

Since these categories pursue similar procedures, there is a lot of overlap between DME and HME billing. Nevertheless, the key disparity is the kind of device ordered and provided to a patient. As a result, DME billing follows the same procedures as HME billing.

Creating a Stable Foundation

You should review the current DME/HME billing processes if you want to tweak your current strategy or introduce new solutions. Only extremely skilled DME/HME facilities and billing workflow will guarantee increased revenue. The claims management process is plagued by errors and mistakes in HME billing. Hence the Accounts Receivable (AR) collections have a huge impact on overall healthy cash inflows.

So now the question is:

Are they resulting in inefficiency, backlogs, or sales losses? If that’s the case, take the following measures to modify your HME billing process:

  • Insurance coverage verification:

This is necessary to make sure that when DME and HME suppliers are paying, the patient’s insurance policy is carefully reviewed, and the equipment is protected by Medicare or insurance. If this is not the case, payment delays and resubmissions could occur, which could be costly in the long run.

  • Experienced and skilled personnel

HME billing workers must be highly trained and knowledgeable on all of the different laws and complex procedures that must be followed when submitting claims.

The constant changes in healthcare can have a significant effect on RCM systems, and reimbursement rates for DME/HME services can drop dramatically. As a result, a professional worker who is up to date with all such regulations will avoid this.

  • Stringent Coding

Coders should be familiar with coding, particularly when it comes to billing services for HME. A minor claim code mistake, such as entering an obsolete modifier or transposing a number, may result in a discarded or denied claim, resulting in a loss of timely reimbursement.

  • Effective Claims Management process:

Following up on claims is another significant and successful phase in ensuring a smooth HME billing workflow. Many HME providers lose out close to 7% of their reimbursements due to rejections. Any medical practice’s RCM will suffer as a result of this inadequate claims management process.

  • Advanced Technology

According to an American Medical Association survey, medical offices spend around $14,600 a year on phone calls, troubleshooting, and appeals to resolve dismissed claims.

Electronic health records (EHR) automation, improved Practice Management systems, better monitoring, and alert systems can all contribute to making the claims process a much more efficient and fruitful tool for increasing A/R collections.

Recently, some HME billing software has become available on the market:

  • Brightree
  • Fastrack
  • Kareo
  • OPIE

All of this software offers a robust, dependable operational arm that streamlines the complex HME billing process and reduces the risk of errors.

What you need to do is take a methodical approach and follow the steps outlined above. The DME/HME billing services can be improved, allowing you to implement a much more effective AR collection process.

Whether your business requires complete billing services revamp or just a few tweaks, keep in mind, it’s always vital to consider your staff and the patients. What may work for one HME billing sector may not work the same for another. Bottom line is to make sure that your reimbursements continue to flow and maintains a stable and profitable Revenue Cycle Process.