An Approach Superior Than Brightree Billing Service

In the Medicare bidding program 2021, the Single Payment Amounts for a lead item will be equal to the maximum bid offered for that item by the bidder according to the final rule which was issued on 14th November 2018. Furthermore, CMS is also implementing the lead item pricing methodology. This means rather than submitting each item within the product category bidders will only submit one bid for the entire lead category. With all this pressure of the Medicare competitive bidding program and the bidding process, everyone is looking for a perfect solution to deal with during the Medicare Bidding program.

Brightree Billing Services

How Sunknowledge can help for a successfully Medicare bidding program:

Sunknowledge Service Inc a decade old 100% HIPAA compliant can be a huge asset in your Medicare bidding program 2021 as our successful guaranteed measures to reduce 80% operational cost will help you bid at the lowest price. With decades of working excellence, our billing executives are experienced with several industries standard and billing software like SOS, Meditech, OPIE, Team DME, Fastrack, Brightree billing service and many more making us unique. Even our 97% first pass collection rate with our well equipped AR analysts is the highest collection rate in the medical billing industry, which no other medical billing organization can offer.

Our 99.9% accuracy rate helps us achieving the highest productive metric and great reference from the top client too. We are in fact the proper tailored customized RCM offering a better solution than brightree billing service for your medical billing problem.

Service we excel:

  • Entry of Rx order
  • Entry of patient’s demographics and insurance
  • Dx Entry
  • Eligibility verification
  • Collection of complete Rx
  • A complete collection of documents for Authorization approval
  • Submission
  • Rejection/denial claims management
  • AR Follow up

Other benefits:

  • No binding contract
  • Standalone/end to end service
  • Liability insurance of $3 Million aggregate with a $1 Million coverage per incident through Hiscox /Geico.
  • Operational transparency with no hidden cost

Speak to us:

For more information speak to our 24*7 dedicated account manager helping you with effective solution for your medical billing issues better than brightree billing service. So call us over a ‘no commitment call’ and increase your ROI by leveraging Sunknowledge Support.

It’s Time for Your DME Medical Billing Checkup

Keeping up with the complex process of reimbursement and coding is a challenging job as far as DME medical billing is concern. The DME specialty is quite different from other specialties and requires in-depth knowledge about coding which is why healthcare finds outsourcing their DME medical billing much cost effective. According to the Black Book Survey, outsourcing will be the only solution by 2022 with an average cost reduction in hospital by 24% to breakeven. The survey also says 98% of hospitals leaders are determined to outsource for a cost-effective result in both clinical and non-clinical functions, helping healthcare organization focus on administration and patients care.

DME Billing

Outsourcing checklist:

Key metrics: the outsourcing organization that offers the highest key metric is the key to profitable revenue generation.

Collection rate:  many hospital and healthcare organization are too slow in collecting the fee from the responsible sources. This also indirectly affecting the whole revenue cycle, as it causing deterioration in the quality of technology and also in patients care. This is why outsourcing organization is specialized in such services, with a dedicated team only for the collection.

Efficiency denial management: a denial management specialist is always necessary as denial claims can rapidly increase your cost to collect and also your account receivable cycle. Outsourcing offers such specialists who can quickly analyze your denial claims and work according to it in order to reduce aging AR.

Benefit offered: with the rising competition in the outsourcing industries in medical billing sector, it is very vital to analysis the benefit offered from different outsourcing option.

Sunknowledge checklist:

Highest productive metrics: with more than 100 clientele including Medtronic, we have the highest productive metric in DME medical billing with revenue of 1.6 billion annually.

97% collection rate: with dedicated resources and decades of working e, we have the highest collection rate in the medical billing industry. Our 97% collection rate even from ageing account is one of our specializations.

Trained resources for denial management: we guaranteed a 24-48 hr response back time for every denial. In fact, our 99.9% accuracy rate in billing and coding is also one of the reasons that we have a lower denial rate as compare to others.

Other benefits:  being one of the finest solutions to your DME medical billing and other specialties. We also have no cost dedicated account manager 24*7 for any of your billing issue. It doesn’t end here we also have no binding contract with operational transparency and guaranteed 80% cost reduction.   Even no open balance is written off without formal approval and we also have Errors of Omission & Commission Insurance support from Hiscox/Geico with a Liability Cover of $1 million.

Leverage Sunknowledge amenities:

Sunknowledge Service Inc is a perfect operational extension with 100% HIPAA compliant and real-time eligibility check helping you focus on patients care. So Leverage Sunknowledge benefit and experience streamline operation with increased profitability for your DME medical billing. For more information speak to our expert over a ‘no commitment call’ so that our expert can understand your medical complication and work out effective solution to our DME medical billing and other medical billing specialties.

Profiling DME Billing, as an Important Part of The RCM Industry

Here’s chronicling the profile of DME billing as against the modern backdrop of the medical revenue cycle management industry. Also profiling the billing essentials of DME and the recent developments of the related industry following the CMS dictate.

What is DME?

DME or Durable Medical Equipment means artificial medical equipment meant for external use to reduce pain, relax muscles, treat ailments, facilitate movements and aother physical phenomenon like breathing. DME also helps patients in recovering from post-operative pains. These goods are recommended by the doctors for use by patients in a domestic atmosphere, manufactured and supplied by specialized companies dealing with them. The various items included in this bracket are iron lungs, oxygen tents, nebulizers, CPAP, catheters, hospital beds, wheelchairs, blood testing strips, breast pump blood glucose monitors, etc. Often DME is referred to as Home Medical Equipment or HME.

DME is essentially an article of medical use by a non-professional person like the patient’s family member. It is further characterized by its durability which differentiates it from expendable items like bandages, rubber gloves, etc. In the industry parlance the term DMEPOS or durable medical equipment, prosthetics, orthotics and supplies also define the item DME apart from the term HME.

DME is normally availed with the help of a physician’s prescription, with the help of which it is acquired from suppliers as well as specialty shops available across the country. The process of DME reimbursement is explained hereunder.

Orthotics Billing

What is DME billing?

RCM or revenue cycle management refers to reimbursement of the medical expenses incurred by a medical facility provider for a patient from the associated insurance organization. The procedure starts with the patient visiting the health care facility for treatment. The facility varies from the nursing home to DME suppliers. After the required service is rendered the process of medical billing and revenue cycle management starts with the provider referring to the insurance references code of the patient and tendering a prior auth request with the insurance payer. Thereafter the request is followed by the RCM practice in order to pursue the required steps of the RCM cycle until the expanded money is recovered from the insurance payer. In the case of DME billing, the RCM cycle is duly adjusted as per the demands of the provider.

The practice of RCM procedure started with providers billing for themselves with the help of their in house clerical staff. But the medical RCM practice being a complicated procedure, it demanded deft professional handling. Hence was formed the concept of customized billing agencies who would deal with different medical facilities like DME etc in their billing and revenue regeneration. Today there are many medical billing organizations across different nations who are adept at meeting the RCM responsibilities without wastage of time and resources.

The Essentials of DME billing

The process of DME billing is as follows

Prescription: A physician’s prescription is required as a must for the Rx reference and for the magnitude of the DME claim.

Verification: The patient demographics and associated data should be checked and accurately mentioned in the related forms.

Credentials: Meeting the credentialing needs is a must before applying for the reimbursement.

 Form: The billing has to be electronically processed

Documentation: Details like the treatment plan of the doctor along with the time period of the DME usage etc should be recorded.

Codes and modifiers: Important indicators like the HCPC codes, procedure codes, maintenance and repair modifiers codes, etc should be mentioned.

Factory Invoice: It should contain the item description along with the physician’s certifying signature etc.

Dates: Important timelines like the date of injury, date of service, etc are also important for the sake of records.

Supporting documents: Papers like chart notes, surgery notes, etc should be attached

Coverage: This process starts with the delivery and installation of the item at the patient’s place

Repair claims: Such claims are billed along with the main service explanation         

The Present Situation

CMS or the Centre for Medicare and Medicaid has recently mandated that all Medicare-enrolled DMEPOS whether bid winner or not are entitled to supply as many beneficiaries as possible, thus increasing the scope of DME billing manifold in the open market environment.