Increase Your Billing Success While Weathering DME Storms in 2022
Durable medical equipment (DME) owners are familiar with the unexpected changes that can occur within the industry. Learning how outsourcing can provide you with valuable strategies to succeed even during challenging times can lead you to increased growth for the future.
A Year of DME Storms
The DME industry contended with and overcame many obstacles in 2021. Unfortunately for some providers and suppliers, it was a challenging year. Learning how to withstand these disruptions and succeeding through them is an all-important task for DME owners.
How can you learn to weather DME storms while ensuring your business comes out ahead of the curve? The answer is working with a trusted and reputable partner who’s dedicated to your success because when you succeed, they succeed.
Outsourcing – An Industry Game-Changer
The primary purpose of a DME billing company is to review the quality of your claims to provide timely payments and lower your day sales outstanding (DSO). If you find the right company to work with, then the partnership results in more significant advantages than claim approvals and lower DSOs. A trusted company can help your company grow, improve overall efficiency, and, most importantly, weather DME storms. Outsourcing DME billing is something many DME providers do. Contact us for a quote on how much DME billing services would cost for you.
What You Should Know about Medbill
Medbill is a DME billing company with a staff of DME billing experts. Our team stays educated on current and upcoming regulations that could impact your business, including claim payments. By continually monitoring industry policies, increasing our internal efficiency, and showing tangible results, we help our customers achieve their business goals even faster.
Utilizing Outsourcing to Overcome Industry Obstacles
Whether or not you were directly affected by some of the industry disruptions in 2021, you were aware of how they significantly impacted a majority of DME providers and suppliers.
Do you know there are ways outsourcing could have assisted you through those times? Learn how Medbill aided other DME businesses and how you can prepare yourself for success in 2022.
1. Philips Respironics Recall
Due to the potential health risks of a component detachment, Philips Respironics recalled thousands of CPAP, Bi-Level PAP, and mechanical ventilator devices. As a result, DME providers were impacted through receiving numerous patient calls, navigating insurance policies, and struggling with product shortages.
Outsource Solutions: Instead of navigating the crisis on their own, the Medbill team guided DME providers by:
- Training and advising staff on managing, directing, and handling patient calls.
- Assisting DME billers in evaluating insurance rules and requirements.
- Searching for comparable replacement devices for patients.
Medbill supported undersigned medical societies and patient advocacy organizations throughout this recall, encouraging The Centers of Medicare and Medicaid Services (CMS) and private payers to suspend specific rules.
2. Ongoing Public Health Emergency (PHE) & COVID-19 Mandates
The COVID-19 PHE began January 31, 2020, and after several renewals, the expected end date is January 2022. Throughout this PHE, DME providers have seen CMS policy suspensions, audit postponements, and COVID-19 vaccine mandates.
Outsource Solutions: To ensure you maintain compliance and regulation requirements, Medbill actively participates in several organizations and state associations. This allows our team to educate DME providers on upcoming changes.
- Provide clarification and answers on billing guidelines regarding the CMS Local Coverage Determinations (LCDs) and specific in-person encounters.
- Maintain ongoing education for everything occurring within the industry.
- Advocate for industry changes through our memberships.
3. Product Price Increases and Operational Changes
Since 2020, supplier rates on products and operational expenses have been based on outdated competitive bidding results that only worsened after the start of the PHE. While changes are slow, the Medbill team has been at the forefront of these updates.
Outsource Solutions:
- New DMEPOS Oxygen Rates – Guided providers on the additional reimbursement cuts to oxygen products while explaining how the updates impacted rural and non-rural areas.
- Educate Decision Makers on Price Changes – Worked with industry stakeholders to prompt Congress, the Administration, and other third-party payers to implement market-based rates for suppliers.
- 5% CPU Adjustments and Paused PAYGO Cuts – Led providers through the competitive bidding areas increased adjustments while training billing teams on how the sequestration cuts will work in the first, second, third quarters of 2022.
The Medbill team will continue to advocate and support organizations that are informing lawmakers on sustainable reimbursement rates to meet the increased DME costs and operational expenses.
4. DME Staffing Shortages
Finding skilled and reliable staffing is a growing challenge for many DME owners. Most employees either lack the necessary skills, are unreliable, or overworked and unable to handle their responsibilities properly.
Outsource Solutions: Medbill employs a high-level staff of 100+ people who are readily available to assist in many situations by:
- Providing ongoing training and education for current and new employees to reduce turnover and overworked mistakes.
- Reducing staffing needs and developing repurposing plans for current employees.
- Scaling with you as the company grows makes it more effective than hiring and training employees.
Employing a 100% US-based staff, the Medbill team focuses on your core values to help you achieve your goals (staffing, billing, income, claims accuracy, and more).
CMS Guideline Changes and Adjustments
For DME owners, one consistency you can rely on is changes and updates from CMS. They are responsible for billing guidelines, audits, coding regulations, and various insurance requirements. Many of these changes are implemented quickly and can be confusing to navigate when submitting claims. However, as DME billing experts, the Medbill team is readily prepared for these changes and teaches your staff on changes that involve them.
Outsource Solutions:
- Adjustments for 900+ HCPCS Codes – CMS made the necessary corrections after announcing numerous DMEPOS fee schedule errors. Medbill helped DME suppliers review submitted and paid claims to ensure proper payment was received and, if not, submitted requests to process corrections.
- Medicare Requirements on SWO and Frequency – Anticipating uncertainty on new changes, Medbill prepared documents that dedicated providers to understanding Standard Written Orders requirements and frequencies.
- ICD-10 Code Updates – This year 205 new ICD-10 codes were added, and 39 were removed. The Medbill team kept providers current on these changes, so claims were paid without delays.
Conclusion
Change is inevitable, yet you can prosper through those times with the right industry partner! At Medbill, we’ll navigate you and your staff through the evolving DME industry. We focus on providing accurate data with tangible results to know how and why your business is succeeding. Contact us to learn more.