DME Prior Authorization Services = More Paid Claims

Do you remember that feeling you get on the first warm day of spring after a long, cold winter? As the sun shines down on your face, you feel so relaxed and happy in that moment that all your worries stop. Now imagine that same emotion when you look at your AR statement and see all the paid claims for the month. 

If you’ve noticed a consistent claim denial trend, it’s time to address the situation. Providing your patients with valuable medical equipment that helps with their daily life is important, but make sure it’s not at the expense of your business. Learn how you can take your company to the next level by outsourcing your DME billing needs. 

DME outsourcing companies provide claims management and prior authorization services to help suppliers submit clean and accurate claims. So, if you want to move your business forward and feel that bright warm sun on your face when you’re in the office, keep reading to learn what you need to do to make that a reality. 

DME Prior Authorization Services Keep Your Business Moving Forward

Currently, many DME suppliers are dealing with overworked, understaffed billing departments. And when this happens, mistakes occur more frequently than usual (even under the most thorough internal procedures). Since receiving claim payments on time is vital to the company, denials can cause significant setbacks. 

There’s hope if you’re trying to manage your claim denial rates! When you work with the Medbill team, you work with the DME billing experts. As a result, you gain access to a team of professionals who are the best at what they do without the hassle of searching, hiring, and maintaining employees yourself. 

Depending on your needs, our DME billing services can increase your claim approval rate, so you spend less time resubmitting claims or losing valuable money from denied ones. Our billing and prior authorization services keep your business moving by:

  • Looking for ways to strengthen your current billing processes 
  • Working denied and unpaid invoices
  • Educating your staff on payer policies and guidelines
  • Maintaining proactive follow-ups to maximize collection
  • Keeping you current on billing and coding regulations
  • Reducing your labor needs and costs 

Do you Know About CMS’s Prior Authorization Program?

Sometimes we talk to suppliers and learn they know very little about the Centers for Medicare & Medicaid Services (CMS) prior authorization program. This industry initiative assists DME and DMEPOS suppliers when providing equipment to patients. 

The CMS prior authorization program helps to ensure that the patient has adequate Medicare coverage and that your claim meets all requirements before you deliver the equipment. This is especially important because some supplies require face-to-face encounters, written orders from a physician, or prior authorization before paying out a claim.  

If you choose to use this service, your billing team will submit the prior authorization request, and you’ll deliver the patient’s supplies after you receive approval. CMS also provides a pre-claim review program that is similar, but you can deliver the patient’s order before you receive approval.

Learn more about prior authorization and pre-claim review initiatives here.

Do You Want More Information on Increasing Your Approval Rates?  

We provide the industry with valuable DME billing information for free on our website to help suppliers submit accurate claims. Review all our articles and white papers here. 

And when you’re ready to take the next step towards strengthening your claim approvals, contact us. We’re here to help you feel the sun shining down on you every day you’re in the office!