How Do You Improve DME Billing Revenue By Reducing Denial?

Denial is a typical difficulty that every healthcare professional faces in today's competitive DME billing sector. In reality, $262 billion out of $3 trillion at claims was refused in hospitals across the United States in 2016.

In addition, according to studies conducted and published by Change Healthcare, 2017:

  • Approximately 9% of claims submitted are initially refused.

  • The typical health institution loses $4.9 million per year due to denials.

  • Across the country, hospitals typically spend close to $9 billion in administrative expenditures to recover disallowed income.

  • Hospitals may have to rework up to 3% or more of their net patient revenue owing to denials.

Many doctors are currently concerned about finding solutions that will make their practice management priorities easier. With demand for hospital items and respiratory supplies at an all-time high, DME providers have been put under a lot of pressure.

The key drive that lies ahead for durable medical equipment vendors is to improve their procedures and systems in order to get payments in the most efficient manner possible. All you need right now is someone who can help you increase your reimbursements. When it comes to reimbursements, it's difficult to find competent experts who assist you with optimizing your DME billing efforts.

However, while denial in DME billing is a prevalent and unavoidable problem, the denial rates can be decreased if caution is exercised. Aside from that, these are the top three strategies to reducing the impact of denials on your bottom line:

Confirm that all claims are submitted correctly

Evaluation of data prior to claim submission is critical since it minimizes the likelihood of errors. As a result, lower denial rate saves money for the healthcare system. Saving a considerable amount by reducing denail costs, as a result of all the rigorous inspections and appropriate verification during claim submission, also saves billers hours of rework.

Detailed understanding of the process

A biller must have a thorough awareness of all aspects of a flawless DME billing process, from the data that must be collected to identify the latest industry mandates and billing legislation. It is also one of the methods for lowering the refusal rate in your DME billing procedure.

DME billing services can be outsourced

Acknowledge clinical areas or departments that seem to be having difficulties with certain processes. Outsource these processes to organizations that take special care in handling the DME billing process with the assistance of

  • Robust reporting

  • Highly experienced billers and certified coders

  • Recognizing process breakdowns

  • Gaps in policy compliance

Outsourcing assumes full billing responsibilities, including data entry, authorization verification, and claims management, among other things. It also relieves the burden on healthcare practices, allowing them to focus on their core work of patient care.

Sunknolwedge provides the most reliable platform

We have served the biggest names with trust and excellence over the last decade. We currently have bench strength of over 2000 resources working solely in the DME space. The best part is, we create a perfect plan to define your ROI goals as per your mandate. Currently, our client references attest to how we have raised the bar in delivering complete and competitive DME billing services under one roof.

Indeed, in today's global world, Sunknolwedge is the only operational extension that not only contributes to minimizing your DME denial rate through stringent checks but also reduces your operational costs by 80%.

Sunknowledge, as a complete RCM organization guarantees 99.9% accuracy in the billing and coding process while charging as little as $7 per hour. We offer no binding contracts to our clients in addition to having a thorough understanding of how to efficiently analyze account history, making sure a prompt turnaround to recovery, appeal denied claims, and closeout A/R.