Physicians who are part of DME services now face an important operational decision: whether to persist with in-house billing staff or entrust to external sources. The long-held belief that in-house billing staff would manage DME-related billing complexities seems to have failed them recently – most of the in-house-staff-managed DME billing are reported to have high incidence denial, delay, or under the realization of DME bills from Medicare, Medicaid, and private DME health plans. And, now that physicians strongly feel the reason to replace in-house DME billing, should they be embracing outsourced DME billing straight away? Yes, but not before they debated the pros and cons of DME billing outsourcing.
Arguments in favor of DME Billing Outsourcing |
- The primary argument in favor of outsourcing DME billing is that it will bring a fresh perspective to hitherto stereotyped practices – outsourced DME billing providers, with their specialization, could iron out deficiencies, and improve realization. The in-house staff, on their part, will be able to concentrate on clinical priorities and prepare reliable data for DME billing and coding.
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- Second, care providers need not worry about capital investment associated with training people and installing systems for DME billing; an outsourced service comes with a ready combination of trained people and systems. Moreover, with a large clientele, it will be easy for your prospective service provider to pass on the economies of scale.
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- Third, outsourced DME billing providers are supposed to have good terms with payers and agencies. They are well-acquainted with Medicaid, Medicare, and private health plans should help care providers in knowing, negotiating, and responding better to the dynamics of DME billing. Likewise, DME billing providers can save you from accepting health plans that are either operationally non-profitable or non-supportive of DME services.
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- Last but not least, DME billing providers can rely on u
- pon to keep A/R days within the permissible limit – with supposedly superior expertise in ICD and HCPCS coding, there should be little need for Decreased denials and/or front-end rejections: as a result of expertise in ICD-9 and HCPCS coding, for re-filing, rebilling or appeal.
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