Stay informed with Medbill’s blog, where we share expert guidance, practical tips, and industry updates to help DME providers navigate the industry’s complexities.
How do DME providers prevent claim denials caused by patient insurance changes? The provider usually finds out about a coverage change through a denied claim — often weeks after it was submitted. Because DME involves long-term rentals billed monthly (sometimes for...
When Medicare adjusted its DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) fee schedule on January 1, 2026, the reimbursement bump ranged from as low as 1.35% to as high as 2.8%, depending on what you supply and where your patients live. And...
Complex Rehab Technology (CRT) and Orthotics & Prosthetics (O&P) reimbursement is not the same as traditional DME billing. These are high-dollar, high-risk claims. A single order can exceed $10,000 to $100,000. Documentation is layered and payer-specific....
January through March can feel like a financial pressure test for many providers. It’s when patient-pay balances surge, deductibles reset, and the cracks in intake, billing, and payment follow-up get exposed.But here’s the truth: Those cracks usually begin months...
One of the most common measurements in determining a business’s profitability is ROI. Return on investment is a fundamental accounting principle that helps companies project whether their investments will result in a gain or a loss. It’s essential for any healthy...
Personalized guidance. Dedicated customer support staff. Improved billing accuracy. Those are just a few qualities you should expect from your DME outsourcing partner. As you continue your search for DME billing management services, make sure to find a company that...
The advent of revised regulations for administrative law judge (ALJ) hearings of Medicare appeals includes a new request for ALJ hearing or review of dismissal form. Because the new form — governed by 42 C.F.R. § 405.1014 — provides a logical flow of information for...
CMS announced a call to discuss the non-CB impact of CURES with stakeholders on Thursday, 3/23 at 2p Eastern. According to the CMN announcement, CURES mandates Stakeholder input on the methodology for using information from the DMEPOS Competitve bidding program for...
With no time to lose, HME industry stakeholders are ready for another run at the competitive bidding program. Legislation in the works by Sen. John Thune, R-S.D., would delay the next round of cuts for nine to 12 months, depending on the CBO score. “This proposal is...
A newly released study by the federal General Accounting Office (GAO) found that the Centers for Medicare and Medicaid Services (CMS) needs to provide better oversight and guidance for provider payment auditors to prevent duplicative post-payment claims review audits....
CMS has announced plans to recompete contracts for Round 2 of competitive bidding and the national mail-order program for diabetes supplies. The agency says it has begun its pre-bidding supplier awareness program, and will announce the bidding schedule and education...
Since last year, Medicaid DME reimbursement rates in Virginia have been posted at Medicare minus ten percent. However, things have gotten worse for Virginia DME providers. On July 1, 2014 DME reimbursement rates for Medicaid dropped to the competitive bidding rate on...
