DME is durable medical equipment as in last blog article you might have read how it is an important part of revenue management cycle. Durable medical equipment is any equipment or device giving advantages for curative or healing purposes to a patient due to specific medical circumstances or ailment and that device can endure repeated usage. Basically, in short, it is a device or equipment which be easily used at home only for medical purposes. DME equipment’s are as follows orthotics, slings, cranes, crutches, wheelchairs, compression sleeves etc. Moreover, many such devices are known as capped rentals. Such devices are used for a short duration in this case rent is more suitable than purchase.

The physicians in orthopedics practice usually give patients with equipment such as casts, canes, and others in accordance with vitality to patients' treatment procedures. To completely comprehend the description and customs for DME can enable practices to take up more efficient choices on which equipment should be allocated to the patient. It also covers the equipment provided is listed and paid accordingly.

DME is generally utilized to suggest to a series of equipment and helpful devices being dispensed from healthcare facilities. Nevertheless, few devices are not incorporated as DME for billing purpose in the coding system. In accordance with the Centers for Medicare & Medicaid Services (CMS), DME is "medically necessary durable medical equipment, prosthetics, orthotics, and disposable medical supplies (DMEPOS), which includes oxygen and related supplies, parenteral and enteral nutrition, and medical foods."

It is essentially utilized only for medical reasons which are not beneficial for the people not suffering from any ailment, pain or hurt and can be easily operated from home of the patient. Few events have DME devices rented, however, mostly in orthopedics it is bought or purchased. Below is the billing & receiving process of DME:

·         Remedy: The prescription is the remedy for the patient's illness it is needed for rented or bought by the patients. It also specifies the quantity of DME required.

·         Confirmation: The confirmation of patient's geographical location and other details should be taken prior to filing for claims.

·         Credentials: In billing process by the supplier of the DME devices, you should fit the credentialing condition prior to applying for compensation or reimbursement. Aside from covered cast supplies, the billing for DME providers continues to go to the DME carrier and not to Medical Part B carrier.

·         Form: CMS - 1500 form should be used for the electronic billing process.

·         Documentation: Secure entire documentation with physician's medication strategy simultaneously with the time span of the DME used.

·         Codes and modifiers: Attach the maintenance, procedure codes, repair modifier codes, and proper HCPCS codes. When a suitable one is not available then utilize E1399 or other HCPCS codes. Along with, a valuable endurance of the products is to estimate about 1 to 3 years. The similar HCPCS is utilized prior to the time passes, coverage can be declined.

·         Factory Invoice: An entire depiction of the item in the invoice in addition to the medical requirement form with the signature of the physician must be added. Despite, it will not send electronically along with claim form. The basic documents will be presented in an envelope at the beginning after which they will be processed electronically. This improves the precision and effective billing method.

·         Dates: The date of injury should be specified for clarity, in addition, specify the date of the services rendered which is DOS, the day the patient deceased or discontinue using DME.

·         Supporting documents: To assure the requirement of the equipment or device, documents such as surgery notes, chart notes, LMN/CMN details should be added.

·         Coverage: It initially begins from the day the device or equipment is delivered and set up to be utilized by the patient at the comfort of any location he or she desires preferably home or a nursing facility.

·         Repairs claim: Every claim is pending bill it with the whole detailed description of the services rendered.

Using other software tools for reporting and dashboards will make access simple to data, payments, check on the held A/R, payments. In addition, it includes the comprehensive analysis of the progress in revenue and merchandise profitability. To enable & assure improved revenue the suitable method for the physician is to dispense the DME from their facility rather than a DME provider.

Check out our webinar related to the same, “Billing And Receiving Reimbursement For DME In Orthopaedics” available on OnlineAudioTraining.