The Home Medical Equipment billing industry constantly changes and evolves with payor policies, reimbursement regulations, and compliance. Learning and maintaining industry knowledge can quickly become a time-consuming responsibility. Companies that take the time to find a trusted HME billing company to work with can increase their cash flow, allowing them to grow their business.
Searching for an HME billing company can be a time-consuming task. However, here are some key points to keep in mind.
- Understand billing services available
- Learn how those billing services can improve the business’s cash flow
- Learn how those services can provide support in the event of a Medicare audit
- Typical questions to ask a prospective HME billing company
What is HME?
Home Medical Equipment, or HME, describes a category of medical supplies and devices used in a person’s home. HME equipment refers to any type of medical equipment or supplies used repeatedly, lasts for 3+ years, and serves a medical purpose.
Examples of HME includes:
- CPAP machines and supplies
- Hospital beds
- Oxygen tanks
- Prosthetic devices
- Wheelchairs and accessories
What is the Difference Between HME and DME?
Durable Medical Equipment, or DME, is another name used to describe home medical equipment. Durable Medical Equipment, Prosthetics, Orthotics, and Supplies, or DMEPOS, is another acronym used to describe home medical equipment within the industry.
Part of the HME billing process includes claims submission to the patient’s insurance company (Medicare or private insurer) and ensuring payment is received. The HME industry requires billers to follow current regulations while staying compliant with billing guidelines in order to decrease denials and increase cash flow.
Outsourcing HME Billing
Outsourcing HME billing services could be overwhelming at first. Take time to conduct research and interview companies to find the best fit. Here’s a brief overview of what to look for when searching for an HME billing company.
HME Billing Services
HME billing services allow companies to improve their daily billing operations without adding additional staff. An outsourced billing company provides many services, including:
- Review claims before submitting them to payors
- Check claims for accuracy and compliance
- Oversee claims submission
- Identify potential problems early on
- Revenue cycle management
- Resolve AR problems
HME Billing Solutions
Outsourced HME billing solutions give businesses access to trained billing specialists. These specialists stay current on all industry-related payor guidelines and news to effectively review claims for accuracy. As a result, HME billing solutions help to free up additional time and resources within the business.
HME Billing and Consulting
There are many HME billing and consulting companies that provide billing services. It’s important to note that no two companies are the same. Make sure to research and interview potential companies before selecting one to work with to ensure the most knowledgeable and trusted company is selected.
How can HME Billing Improve Cashflow?
HME billing services allow companies to improve their internal processes, find potential problems, streamline their services, and effectively manage claims submission. Here are five ways HME billing services can help a company increase its cash flow.
1. Increase Claims Accuracy
Before claims are submitted, billing specialists will review them for accuracy and make sure it’s compliant with current industry guidelines.
2. Become Audit Ready
From intake to claims submission, all claims are thoroughly reviewed. So in the event, there’s an audit, a system is already in place that can effectively meet any audit requirements.
3. Streamline Cash Posting Processes
An HME billing company can ensure claims payments are received and properly distributed. A cash posting system will check to primary cash posts for errors to prevent secondary and third payer errors.
4. Manages Specific Tasks
Some HME billing companies, like Medbill, can customize services for a business’s specific needs. For example, the billing team can review specific setups or steps so the company staff can focus on other tasks.
5. Review Denial Trends
HME billing specialists can review common claims denial reasons and look for any trends. Finding and correcting these trends will help to streamline the claims submission process and result in faster payments.
Medicare Claims Audits
There are several Medicare audits conducted to help ensure claims submissions are accurate and correctly paid. Companies are usually randomly selected, and if requested, businesses should respond by the deadline, send all requested documents, and begin an internal review.
Here are some Medicare audits.
- Comprehensive Error Rate Testing (CERT) Audit
- Medicare Administrative Contractors (MACs) Audits
- Recovery Audit Contractor (RAC)
- Unified Program Integrity Contractors (UPIC) Audit
Questions to Ask When Interviewing an HME Billing Company
Consider asking the following questions when searching for an HME billing company.
- How do they conduct their document review process?
- Will claim denials be reviewed and managed?
- How will they look for claims rejection trends?
- Do they offer personalized support?
- Will they educate and inform company staff on successful billing practices?
- How do they stay current on changes to payor policies?
- Do they review the A/R process and offer improvements?
What to Expect from an HME Billing Company?
A trusted and qualified billing company, like Medbill, will show businesses how to:
- Shorten DSO
- Reduce operation costs
- Improve collection rates
- Stay current on changing policies
What to Expect when Outsourcing HME Billing to Medbill?
The Medbill team focuses on helping businesses reach their company and staffing goals. During the initial setup and meetings, the team will:
- Explain what the outsourcing transition looks like
- Discuss company goals
- Equip company staff with training, suggestions, repurposing plans, and feedback
- Provide ongoing education on payor guidelines and policies
Medbill’s sole focus is on the HME/DME billing industry. The staff specializes in learning, understanding, and educating customers on everything related to HME billing, especially how HME policies impact claims.
Increase Cash Flow by Outsourcing HME Billing Needs
Outsourcing with the right HME billing company can grow a billing department and help increase DSO, cash flow, and increase time and resources for other areas of the business. Medbill is a top HME billing company with a 100% U.S.-based staff. The Medbill staff is trained and skilled in preparing companies in all aspects of HME billing with personalized support.