Successful HME companies have to overcome obstacles like cutbacks in reimbursements, growing employment costs, and competitive bidding, all of which put additional strain on their billing departments. This often results in backlog increase.
If you are having trouble managing your HME billing, tying with someone who is aware of your overall needs in terms of your revenue cycle will be your best option. What your HME really needs is a diligent partner who can maximise your reimbursements to the fullest extent. Outsourcing seems like a feasible option for when you are facing such hurdles and are looking at implementing a positive HME billing strategy
Many HME providers are aware that technology can benefit their company. You can be missing out on new, fast developing technology that might help increase sales, expand your business, and enhance your referral network. The most recent innovations achieve all of this by emphasising business efficiency and operations expansion, the two areas where many HMEs struggle to be successful.
Effective Billing Strategy with Outsourcing
It’s a common misconception among those who are wary of HME billing outsourcing that outside partners can only do straightforward duties like invoicing and collections; this is far from truth. A reliable HME partner can actually assist in delivering high-quality services in each of the following areas, and eventually assist in growing revenue for your business.
- Order Intake – Filling new orders includes everything from managing incoming referrals received through fax, web portal or email, to entering patient and order-related data. Additionally, eligibility must be checked in order to confirm that patients are eligible for coverage.
- Billing and collections – These procedures ensure that prescriptions and new orders have been filled correctly. The billing and collections division controls denials and open A/R balances, evaluates billing, enables claims transmission, and maintains front-end rejections.
- Prior Authorization – This stage comprises gathering health information and other crucial data, and sending it to payors by web portal, fax, or phone.
- Cash Posting: Cash posting reconciles bank deposits and EOBs and ERNs. Additionally, changes, denials, and payments are applied to the A/R balances in this area.
- Eligibility Verification (EV) – EV entails obtaining information about a payer’s financial responsibilities through payer websites, payment systems, and phone calls. This part influences whether patients’ deductibles are fulfilled, and whether doctors are within the network or not. It also looks at how patients can benefit, and who is responsible for paying for orders.
- Resupply management encompasses many facets of a provider’s resupply operations, from patient engagement to the completion of orders, and it makes sure that this important source of income is prioritised.
Managing HME Audits
Pre and post payment audits are becoming more common for HME organisations, which can be both, stressful and expensive. An audit request can lead to a slowdown, and put your organisation at risk financially if you don’t have a solid strategy and technological platform for keeping correct and retrievable data.
The most recent esMD standards should be used to submit audit reports in addition to automatically locating the appropriate documents and adding them to each claim. Beyond increasing productivity, the correct technology can assist providers in maintaining a healthy cash flow by promptly and accurately addressing audits.
Over the past few years, Info Hub Consultancy Services (ICS) has earned the trust of some of the biggest suppliers by offering HME billing services. With our resources, we can provide comprehensive medical billing and coding services that will completely eradicate any chance of a ROI.
We have a great team in place that reduces costs with our regular presence by over 80%. We believe in the fact that you need someone to deliver everything under one roof so you can focus on other important facets of your business. Our team at ICS is aware of what is necessary to boost revenues and reimbursements.