According to a report by the advisory board, it is seen that 90% of the medical billing claims are avoidable if taken care of.
With common challenges being the billing non-covered or ineligible service marks one of the primary reasons for claim denials to complex rules associated with individual payers, using manual processes etc every reason for denial claims can be avoidable.
The MGMA health insurer report states the most common reason for today’s denial can be categorized as:
- Missing of vital information or having incorrect information or data like patient demographic data
- Technical errors
- Duplicate of the claim submission
- Services not covered by the payer
- The time limit for claim submission that has already passed
- Service that has already been adjudicated etc
Delaying the payment cycle in the DME billing, denial claims not only reduces the probability of payment but also leads to loss of valuable time and money.
In fact, according to the AMA study, it is seen that the money spends on the rework of denial claims is about $15,000 including phone calls, investigative work, and claims appeals etc.
It does not end here, about 43 % of providers spent more than $10,000 in the first quarter on managing the Medicare Recovery Audit Contractor (RAC) appeals process. With another 26% of the healthcare providers spend on more than $26,000.
As all the above denial reasons for the claims can be avoidable, however, healthcare practices still tend to make the same mistake again and again.
This is not because they lack in expertise but not as having an expert billing team. As expert billing team can cause a huge financial burden,
Which is why small healthcare practices tend to end up with one or two-person juggling in between handling billing issues and other administrative work and the reason for denials. This is why outsourced RCM organizations are here to help.
Ensuring a proactive claims denial management system by taking care of patient and insurance information is accurately collected and reported, these RCM organizations take care of all DME billing activities with an assured reduction in the denial rate due to its expert’s team of billers and coders.
Securing that demographic errors do not occur and services are covered by the patient’s plan from the patient’s data entry to eligibility and authorization verification, medical coding to submission of claims; a DME billing operational extension ensures stringent check eliminating all the possible errors.
In fact, today there is much outsourcing revenue cycle management for a seamless DME billing process that provides ala carte basis DME billing services too.
Reducing your operational cost and eliminating all the extra employee cost, their training cost, benefits etc, these RCM organizations ensure complete operational transparency.
With robust reporting to give you a clear picture of your DME billing process, these revenue cycle management organizations also reduce your account receivable bucket which in-house billers are coders takes a lot of time.