Medical Billing Blogs

  One of the keys to any DME facility's success is ensuring the revenue cycle management is effective. It also is directly related to how the patient experiences your service and the ability to innovate. Also, proper revenue cycle management (RCM) means you can reduce mistakes and lower the overall costs of the services. However, this is not possible without an experienced DME biller. A reputed DME biller can help your DME facility comply with the latest billing and coding regulations, minimize errors and optimize the documentation, billing, and coding process. Among the DME industry, it is known that they undergo perennial updates, which is one of the foremost challenges in the services. DME's many challenges include the cost of training employees, shrinking collection, billing errors, and suspension of operation due to staff absence. Any of these problems can lead to not only lowering the revenue but also the overall productivity of the service. So, what are the ways to...

  Revenue cycle management is of utmost importance in any healthcare service. One of the best ways to ensure that, is by outsourcing medical billing and coding services. It offers long-term viability and an efficient way for the medical facility to concentrate on the core activity, i.e., serving the patients. When a knowledgeable outsourcing medical billing partner takes care of the medical billing and coding of the facility, one can experience a constant increase in the revenue, the number of patients, and the overall performance of the staff. Furthermore, by outsourcing the billing process, the facility can maintain income and optimally utilize its resources. If you are still not convinced why you should be outsourcing medical billing services, then let’s evaluate some of its benefits: Improve Patient Focus Whether it is a hospital, a small medical service facility, or an independent practice; managing the administrative work such as medical billing and coding, and docum...

  In healthcare services, pharmacy billing is a crucial aspect. Like other healthcare disciplines, pharmacy billing too has its challenges, which are integral to pharmaceutical companies. There are some drugs and injections that are excluded from the coverage provided by the insurance. It eventually adds to the complexity of the pharmacy medical billing and coding. It is therefore essential that the pharmacy billing staff have a thorough knowledge and understanding of the efficacy that includes and excludes the drugs and other items during the billing process. Overall, pharmacy billing plays an effective part in the patient's care and the revenue cycle management of a facility. Understanding Pharmacy Billing? The management of pharmacy billing and coding is handled best when a professional takes over the work. With the customized and thorough billing service, the pharmaceutical company and the medical services can focus on their core aspect while the professional take care o...

  Skilled Nursing Facilities (SNF) must ensure they get timely payment, for which they need to follow an efficient revenue cycle management practice. The practice needs to look after proper submissions that are denial free for effective account receivable management. The SNF must conduct efficient payer-follow-ups, stay compliant with the healthcare regulations, and do other admin works to warrant their survival in the business. With the increase in the growth of SNFs, which are now being funded by Medicare, Medicaid, and private insurance companies, the facility must be able to stay up with the reforms. In the SNFs, there is quite a significant increase in the regulatory restrictions. In this, the consolidated medical billing and coding has become a patent system in covering the services within the scope of SNF care. Hence the medical biller must have a sound understanding of the inclusions and the exclusions in the consolidated billing to ensure timely reimbursement. Unless t...

  Any DME supplier will always strive to increase revenue while decreasing the day’s sales outstanding. According to Grand View Research, the durable medical equipment (DME) market will grow from $53.6 billion in 2021 to $92.8 billion in 2030. Because of the COVID-19 pandemic and the shift in healthcare toward a hospital-to-home model, the DME industry will be one of the fastest-growing markets. Even as the US population ages, there will be an increase in demand for a wide range of home medical equipment products, from oxygen to incontinence and mobility products. All of this will fuel the demand for DME items and products. Suppliers are now looking to improve their patient loyalty and satisfaction program in order to accelerate the ROI to the best proportions. Low payments, as well as changes in Medicare and Medicaid regulations, are all posing significant challenges. More patients are now paying out of pocket or are unsure how much they owe. As a DME supplier, the last thi...

  The Competitive Bidding Program by Medicare was launched to improve the overall value of Medicare and the money of the taxpayers used in the facilities. The program sets prices through competition, ensuring that the patients' items are of quality and licensed. It also allows only accredited suppliers to bid who must meet the standards set by Medicare. The overall process helps in reducing fraud and abuse of the Medicare system. What Is DMEPOS Competitive Bidding Program? Congress mandated the DMEPOS Competitive Bidding Program in 2003 through Medicare Prescription Drug, Improvement, and Modernization Act (MMA) . The Act required Medicare to replace its then methodology of fee schedule payment for selected Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) items with a competitive bidding process. The program oversaw that suppliers in a competitive bidding area (CBA) compete with each other by submitting bids on a selection of products. The program eval...