Earlier this year, HME News reported on the growing staffing pressures and rising labor costs facing DME and HME providers. Many are struggling to maintain efficiency and compliance amid increasing expenses and a tightening labor market.
With reimbursement rates largely fixed by payers and operational complexities mounting, providers need new strategies to keep their billing teams running smoothly and their cash flow steady.
AI-powered tools can empower lean billing teams to work smarter, not harder, helping you navigate staffing shortages while maintaining accuracy and service quality. Let’s dive into how.
First, Why Are DME Staffing Challenges So Difficult to Solve?
DME providers today are under pressure to hire team members with deep regulatory knowledge but without the revenue margins to offer truly competitive wages.
Several factors compound the challenge of staffing billing roles in this environment:
- Reimbursement rates are fixed. Because payments are largely dictated by payers, providers have limited flexibility to raise prices or adjust for rising labor costs.
- Inflation is outpacing reimbursement. As wages rise across the economy, DME businesses are stuck operating within reimbursement models that haven’t kept pace with rising labor costs.
- The work demands specialized knowledge. Staff must understand payer rules, documentation requirements, and compliance risks (all of which are constantly in flux).
- Turnover drains time and resources. When experienced employees leave, providers face long ramp-up times and added training demands for new hires.
Staffing strains have ripple effects. Teams operating with fewer people are more likely to experience burnout, turnover, and operational inefficiencies. Gaps in knowledge and capacity can lead to delayed claims, billing errors, and increased denials, which put compliance and cash flow at risk.
AI: A Strategic Tool, Not a Replacement Plan
Chris Delposen, Medbill’s managing director, puts it like this:
“AI won’t replace people, but people who use AI will replace people who don’t.“
That mindset is key for providers navigating staffing challenges. The most successful teams aren’t using AI to replace staff—they’re using it to empower them. By automating repetitive, time-consuming tasks, AI frees up your billing staff to focus on work that requires their expertise.
The results speak for themselves. Research shows that AI-powered billing systems can:
- Reduce coding errors by up to 50%
- Decrease claim denial rates by 30–40%
- Cut processing time by 60%
With the right tools and training, lean billing teams can not only keep up but get ahead.
Where Can AI Make a Measurable Difference?
AI and automation can step in where manual processes slow your team down, especially in high-volume, repeatable workflows.
Workflow Automation
In many DME billing departments today, workflow inefficiencies are built into everyday routines; lots of clicking between screens, manually checking order statuses, routing documents, and verifying patient eligibility. These repetitive steps drain time and energy, especially when they are repeated dozens of times a day.
By contrast, AI-driven workflow automation can trigger those same tasks automatically (order status updates, eligibility checks, document routing) and route items directly to exception queues. This frees your staff to focus on problem-solving and customer service, instead of getting bogged down in routine processes.
Cash Posting
Similarly, cash posting can be a bottleneck for lean billing teams. Without automation, staff often apply payments from ERA files line by line, pausing frequently to resolve mismatches or enter adjustments manually. It’s tedious, error-prone work that slows down the revenue cycle.
AI-powered systems can shift that burden. With rules-based logic, payments can be matched and applied automatically, denial information can be posted automatically and used in automation steps, while exceptions are flagged for human review. This cuts down processing time, reduces errors, and enables efficient re-processing of claims. That kind of speed and accuracy can help teams stay on track, even when you’re short on staff.
Resupply Automation
When it comes to resupply outreach, providers often rely on manual phone calls, emails, and spreadsheets to track timing and follow-ups. This approach is time-consuming and prone to missed touchpoints.
AI-powered tools like TrueSight can automatically initiate outreach based on eligibility and timing rules, delivering reminders via text or email and escalating only when human follow-up is required. The result: more consistent resupply compliance with less staffing.
Document Management & Order Validation
Billing documentation and order validation is another high-touch process. Historically, staff review each order, chase missing documents, and validate details before claims are submitted.
With AI-enhanced document management and validation, the system checks order fields and documentation completeness in real time, flags missing items quickly, and improves claims accuracy, making billing faster and cleaner, even with fewer hands.
Patient Communication
Consistent patient outreach is essential to a successful resupply strategy, but it’s also one of the most time-consuming parts of the process. Between appointment reminders, document requests, and follow-ups, it’s easy for messages to slip through the cracks when staff are stretched thin.
AI-enabled texting and email tools help ensure no opportunity is missed, without adding to your team’s workload. Platforms like TrueSight can automatically send timely reminders, gather missing information, and prompt patients to reorder supplies. By handling routine communication more efficiently, AI frees up your staff to focus on higher-value tasks and patient care.
Educate Staff on Secure, HIPAA-Compliant AI Use
Yes, AI can streamline billing, communication, and documentation, but it must be used carefully.
Any tool that touches patient data must comply with HIPAA privacy and security requirements.
To keep your organization protected, train staff on these essential best practices:
- Only use HIPAA-compliant AI platforms. Any software handling protected health information (PHI) must have proper safeguards in place, including encryption, access controls, and audit trails. Additionally, Business Associate Agreements (BAAs) should be in place with all vendors.
- Never input PHI into public or consumer-grade AI tools. Tools like ChatGPT, Google Bard, or other open-access platforms should not be used for tasks involving patient names, medical histories, or insurance data unless they are part of a HIPAA-compliant enterprise solution.
- Limit AI to appropriate tasks. Use AI to assist with tasks like claim status checks, resupply reminders, or document classification—not for making clinical decisions or final claim determinations without human oversight.
- Establish clear policies and training. Staff should know when and how to use AI tools, what data is safe to share, and how to report potential breaches or misuse.
By pairing innovative AI tools with strong internal safeguards, you can reap the benefits of automation without putting sensitive data or patient trust at risk.
You might like: What the HIPAA NPRM Means for DME Providers—and How to Prepare Now
Preparing Your Team for AI Adoption
Successfully applying AI to your billing operation requires effective change management. To get started:
First Things First: Audit Your Workflows
Where is your team getting bogged down? Use billing analytics and KPI reports to identify where delays and errors occur, such as documentation review backlogs, slow payment posting, or frequent resupply follow-ups.
These bottlenecks often reveal high-volume, repetitive tasks that don’t require complex decision-making, making them ideal candidates for AI support.
Start Small and Focused
Don’t try to overhaul everything at once. Choose a tool that can alleviate a specific bottleneck in your billing process and prove its value before scaling up.
Lean on a Partner With Industry Experience and Tech Capabilities
The right team can guide you and your team through this implementation process. Medbill combines human expertise with AI-powered tools like TrueSight to help providers adopt automation sustainably, without compromising compliance or performance.
A Smarter Way Forward—With People Leading the Way
AI isn’t here to replace your staff; it’s here to make your processes more efficient, accurate, and manageable for the people doing the work.
With a thoughtful approach to adoption, your team stays in control, gains confidence in the technology, and sees measurable wins that support long-term growth.
Next, check out How AI and Automation are Transforming the Future of Patient Communication.