Are OIG Audits Keeping You Up at Night?

Meet your new billing & compliance team.

95% Claims Rate - 97% Retention - Expert Auditors

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Dr. Stephen Taylor
DOL Consultant

Roger Bach
Former Special Agent (OIG)

Chris Quick
Former Special Agent (FBI & IRS-CI)

Michael Koslow
Former Supervisory Special Agent (DOD-OIG)

Durable Medical Equipment Coding

Definition: Durable Medical Equipment

Any equipment that offers therapeutic benefits to patients in need due to certain medical conditions/illnesses qualifies as durable medical equipment. DME (Durable Medical Equipment) must be medically necessary (i.e., required via a prescription or through pre-authorization) to be eligible for coverage.

This makes durable medical equipment coding different and more complex when compared to other medical billing and coding. Healthcare facilities require personnel with specialized knowledge of all applicable codes and overall reimbursement process. However, it may not be economical to maintain full-time DME staff. That’s where outsourced medical billing comes in.

Put our highly experienced team on your side

Dr. Stephen Taylor

DOL Consultant

Roger Bach

Former Special Agent (OIG)

Chris Quick

Former Special Agent
(FBI & IRS-CI)

Kevin Smith

Former Assistant Regional Inspector General

Michael Koslow

Former Supervisory Special Agent (DOD-OIG)

Beverly Gibson

Director of Coding

Wade McFaul

Former Assistant Special Agent-in-Charge (HHS-OIG)

James Hunt

Former Special Agent-in-Charge (DEA)

Introducing Fortis

At Fortis Medical Billing, we have DME experts (billers and coders) who know how to code medical claims whether the medical equipment is purchased or rented.

Our durable medical equipment experts also know everything required to bill, when to claim, how to guarantee timely reimbursement, and how to adhere to the stringent quality and compliance framework.

Regulations surrounding DME coding and billing keep changing. Our team of DME experts is always up to date with the evolving legal landscape. We will also advise on document practices as per Medicare and Medicaid guidelines and more!

Our DME Coding Service

Fortis monitors DME coding constantly from start to finish. Our services include:

Accurate Data Collection & Entry

Our DME coding experts gather accurate information on DME providers and enter that data accurately into databases. The coding and billing are guaranteed to be 100% error-free. We conduct in-depth DX and CPT code reviews, ensuring acceptance. We also insert appropriate modifiers and set DX codes to ensure accurate documentation and process DME coding and billing documentation once providers establish a need for durable medical equipment.

Issuing Statements for Practices

We send our clients statements customized to their unique specifications. Our accurate and brief routine statements ensure errors are “caught” and corrected in time.

DME Coding Audits

We conduct stringent audits that ensure data accuracy. Our audits are conducted by expert coders who focus on physician notes, lab reports, and other documentation. We also offer updated records in the process. Our audits ensure reimbursement amounts match those on record. Our qualified DME coding experts are always checking for coding issues in claim documents and regulatory compliance obligations.

Denial Management

If claims are denied due to DME coding issues, we file appeals on behalf of our clients. Our durable medical equipment coding experts assist in navigating payment discrepancies that are challenging to handle without expertise in carrier-specific claims procedures. We can handle payment issues linked to non-compliance and more.

Fortis Medical Billing can do much more on DME coding and beyond!

The Fortis Medical Billing DME Coding Advantage

You should choose us for all your outsourced medical billing needs for several reasons:

  • Unmatched team of Durable Medical Equipment coding and billing experts under one “roof “: Our team is composed of former OIG agents, certified coders, DME compliance experts, and consultants who have conducted 1000+ healthcare audits. We have billers, coders, and other experts (including attorneys) capable of handling all DME documentation, DME claims, and related issues from the start to the finish of all medical episodes.
  • Strict data security: We have taken all the necessary measures to ensure data security. We use VPNs, encrypted servers, secure cloud networks, and firewalls to safeguard data.
  • Technology benefits: We deliver fast, accurate, and reliable services because we utilize advanced DME coding and billing software. We can file DME claims electronically, eliminating the cons of paperwork.
  • High retention and claims rates: 97% of all the medical facilities that seek our durable medical equipment coding services retain us. What’s more, we handle 95% of all DME coding claims and related issues successfully.

When Should You Outsource DME Coding and Related Services?

When You Don’t Have In-House Capacity

Independent physicians, among other independent medical professionals who don’t have in-house medical equipment billers and coders, should consider outsourcing as this would offset many responsibilities, including preparing medical claims via appropriate DME codes and other medical details as well as sending and following up such claims.

When You Wish to Streamline DME Coding and Billing

You can have an in-house DME coding team but still have issues with long-drawn procedures, complex software application, challenging medical/procedural intricacies, and other problems that keep resulting in rejected claims.

Fortis Medical Billing can streamline all Durable Medical Equipment coding and billing issues. We have a consulting model that creates in-house capacity. We start by analyzing your operations in-depth to identify areas we can improve. We can identify in-house staff that require training, and cumbersome processes that require streamlining. We can also recommend appropriate DME software for easier processes and compatibility with your practice and Medicare/Medicaid compliance.

When You Want to Boost Revenue

Outsourcing medical billing services helps medical professionals like physicians run their facilities more effectively. By using medical billing professionals like Fortis, errors are eliminated in the coding and billing process, decreasing the number of declined claims. This, in turn, boosts revenue for the practice.

Outsourcing also frees up valuable time that would be spent by in-house staff handling DME issues. With medical practice staff focused purely on medical activities, revenue is bound to increase. There are also indirect benefits of outsourcing DME coding and billing. For instance, by increasing the percentage of reimbursed claims and ensuring timely repayment, practices have more cash flow to expand and boost profitability.

Having expert billers and coders that can identify the root cause of claims rejections and rectify such issues eliminates slow, tedious, and potentially demoralizing tasks that can affect the morale of inhouse staff charged with other duties. Since staff morale has a direct correlation with profitability, it makes sense to outsource DME coding and other related tasks when the goal is boosting revenue.

Choose Fortis Medical Billing and enjoy peace of mind, increased revenue, and other benefits such as legal compliance advice and representation on medical billing and related issues. Request a free Durable Medical Equipment Coding consultation. Feel free to contact us at (866)-808-4160.

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