The Bikham Advantage for DME Billing
The process for DMEPOS billing can be cumbersome one due to its inherent nature, viz. the order getting generated from a physician’s office. This increases complications and the turn-around time as dependencies increase. The Bikham team understands and comprehends all these complications, all thanks to the decade long experience in handling and pioneering the process of DME billing and coding. The biggest challenge for the DME, Prosthetics & Orthotics companies is that they need to devote much time coordinating and communicating with the ordering physician’s office for a valid Rx, medical/therapy notes, etc. Let us handle all that for you, with ease.
The Follow-up calls for prior auth required equipment is handled with ease by our follow up staff. This is managed effectively by us through our methodical and streamlined process that tracks each request in detail ensuring timely follow-up.
Our AR and follow up teams ‘thorough knowledge of the payer guidelines, specific to diagnosis, results in drastically reducing denials. Our diligent physician and payer follow-up activities also help reduce turn-around time and improve cash flow. Our main goal is to start the process with the entry of orders and end it when the account has a zero balance. This includes conducting eligibility checks, obtaining authorization, creating sales orders, scheduling delivery, submitting claims, managing rejections, and denials, and proactively following-up AR.
We are proud to boast of a happy, satisfied and ever-growing client base since 2005!
If we simplify the above facts regarding DME from a reimbursement point of view, two deductions will spring up:
- The need to establish the necessity of a DME device within a treatment episode
- Knowledge of the devices that are covered
The second requirement is more complicated than it looks; its coverage eligibility is circumstantial. For example, a wheel chair will be covered only when used exclusively for a permanently disabled nursing facility resident and if not included in the nursing facility per diem rates.
Outsourcing to Bikham:
Bikham can simplify the situation for you:
- Our team of billers and coders have years of experience in handling DME documentation starting from the beginning to the end of a medical episode.
- Our billers and coders can help you develop a physiological description of the client’s disease, injury, impairment, etc, and other requirements, including videos and photographs to demonstrate the client’s impairments and ability to use the equipment.
- Our DME billers and coders can help you with the entire set of reimbursement administrative activities starting from accurate identification of the instances eligible for reimbursement through the preparation of claims for submitting them.
Depending on the size and need of your set up, you can choose any service model you want. If you are an independent physician without an in-house team of billers and coders nor any need for it, you can choose our outsourced billing and coding services and we would take care of the complete range of billing and coding responsibilities for you, including preparing claims using appropriate codes and other medical details, submitting them and following up with insurance authorities for their timely reimbursement.
If you are a bigger set up with an in-house team of people handling billing and coding for you who are struggling with long-drawn procedures, bumbling software applications and medical and procedural intricacies leading to rejected claims, all your in-house operations need is streaming up of your billing processes. Our Revenue Cycle Management (RCM) consulting model can help you. We will conduct a thorough study of your operations and strip out cumbersome processes and replace them with leaner and efficient ones, identify where your in-house staff need training and help train them and recommend appropriate software applications that will be easy to use, compatible with your environment and will help you be in Medicaid and Medicare compliance more easily and seamlessly than the ones you have today.
Benefits to Our Physicians:
- Follow-up on incomplete prescription with physician’s office
- Follow-up for document collection (diabetic verification forms, LMN, CMN etc.)
- Error free patient entry
- Error free sales order creation
- 100% HIPAA compliance
- Real time transaction audits
- Primary and secondary insurance verification
- Insurance verification for rental items
- Obtaining authorizations & extending authorization
- Open order audit and clean-up
- CPAP user compliance tracking and counseling calls to noncompliant patients
- Claims submission within 48 hours of receiving proof of delivery
- Rejection follow-up within 24 hours
- Tracking and follow-up of partial or incorrect payments
- Denial management based on detailed analysis
- Methodical and proactive AR follow-up
- Timely payment posting to reflect accurate AR
- Customized reporting