Getting Your DME Billing Claims Paid

Getting Your DME Billing Claims Paid

Many times medical billing questions arise about how to get DME claims paid. Some companies bill for durable medical equipment all the time, while others only do it a few times a year. Following simple medical billing tips will get your Durable medical equipment claims paid as accurately as possible.

It is very important before a product is dispersed to see if the patient needs precertification from their insurance company. If medical billing is performed on a piece of durable medical equipment that needed precertification, but precertification was not obtained, many insurance companies will deny the claim. This may seem like a time consuming task, but in the long run, performing precertification prior to medical billing will save your practice money.

Be sure to obtain an order by a medical physician prior to billing for certain durable medical equipment. Sometimes a formal order is not required, but a signed certification is needed for proper medical billing. Along with this requirement is proper charting of medical necessity. Usually the date of the original order is helpful when performing medical billing.

One important point to remember when billing for durable medical equipment is that the date of service is the date the patient receives the equipment. If a product is sent to a patient, the date of service is when the patient actually receives the product, not the day it was shipped. Be sure medical billing personnel are aware of this fact. The only exception is when a patient cancels an order. Then the date of service is the day the equipment order was canceled.

These are just a few tips for doing medical billing for durable medical equipment. There are always general ideas that work for everything in medical billing, but then there are specific rules. Durable medical equipment has a lot of specific rules. Be sure, before doing medical billing for durable medical equipment, you are educated on the specific nuances of that equipment.

View all Articles by: Melissa Clark, CCS-P