3 Successful Ways To Establish An Effective DME Management Process
Durable Medical Equipment billing is complex as it requires a detailed understanding of how to code claims, what to bill for, and when to submit claims. Recently, there have been several cases of incorrect DME billing, either due to a lack of knowledge or a fraudulent attempt to make money. DME billing fraud comes in a variety of shades and colors. Billing for items that were not ordered or received is a common type of fraud. The discrepancy is revealed in the paperwork known as the Explanation of Benefits (EOB) or Medicare Summary Notice (MSN) . Sometimes fraud occurs when a patient receives equipment not prescribed by the doctor. Other types of fraud include receiving a phone call from someone unrelated to the physician's office requesting Medicare information, billing for duplicate orders, higher-than-normal rental charges for equipment, etc. Insurance companies detect fudged billing with great expertise, regardless of how it is committed. However, they can result in heavy...