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Durable Medical Equipment Billing

The categories of DME include

Mobility Aids

Personal Care Aids

Prosthetic Limbs


Oxygen Equipment

Billing DME Claims

Managing the revenue cycle for DME requires staying up to date with reimbursement and coding guidelines. Documentation needs to be meticulous, as any incorrect information can lead to claim denials and revenue loss. Healthcare providers have a lot to keep an eye on for an effective DME billing process and accurate reimbursement, so they don't waste time and money.


Here are some key steps:


1. Verify the patient's insurance information when placing the order.

2. Gather all necessary documents, such as prescriptions, prior authorization, and certificates of medical necessity, for the claim.

3. Double-check that all claim information is accurate.

4. Submit the claim with the appropriate documentation to the correct insurer.

Durable Medical Equipment

Get to Know About Durable Medical Equipment Billing

Durable medical equipment (DME) includes a range of devices and equipment like wheelchairs, walkers, hospital beds, diabetic supplies, and home oxygen equipment. These are used by people with disabilities or chronic health conditions on a regular basis.


Billing for durable medical equipment can be a complex and time-consuming process. The DME industry often faces regulation changes and audits. To maintain a steady cash flow, it's important to follow a strict billing procedure right from the intake process. DME is typically covered by original Medicare, but the supplies and devices must meet specific criteria. They need to be medically necessary and able to withstand repeated, long-term use at home.

Durable Medical Equipment Coding

DME billing is more complicated compared to other specialty billing. DME coding falls under HCPCS Level II. Coding must be done perfectly, with clear and precise definitions for each entity.


Once the doctor confirms the need for DME for a patient's medical condition, the necessary claim submission documents must be prepared. The patient should reach out to a DME supplier, and the coder will verify the prescription and collect the patient's insurance details. After completing the required paperwork, the equipment is handed over to the patient. Medical coding is then conducted using the appropriate codes. The entire procedure is encrypted in the code and sent to the insurance company. The authorization and billing process is carried out to ensure the patient receives the claim amount.


Outsourcing Durable Medical Equipment Billing


Due to the complexity of DME billing, it can be challenging for providers to keep up with changing billing regulations while maximizing reimbursements. Outsourcing DME billing is an effective solution to eliminate administrative headaches, allowing providers to focus on patient care.


By availing DME billing services from professionals like finnastra, you can enjoy the following advantages:


- Skilled team: Get expert advice to improve processes and overcome billing challenges.

- Customer service: Experience rapid responses and efficient customer care through various contact methods.

- Custom reporting: Stay focused on important performance metrics and gain insights into your business's performance.

- One-stop solution: Receive efficient revenue cycle management support at the best pricing.


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How Can Finnastra Help?

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Finnastra is your one-stop solution for all medical billing, practice management, patient management, and revenue cycle management activities your healthcare practice needs. As a Platinum partner among 850+ billing companies, Finnastra has over 20 years of experience in healthcare technology and revenue cycle management services. They provide medical billing service solutions to over 180 practices of all sizes across 31 states, serving more than 28 critical specialties.

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