3 Most Common DME Billing Challenges
                     INFO HUB SERVICES 
3 Most Common DME Billing 
Challenges
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Introduction
DME billing is complex, and Info Hub, a leading offshore DME billing company in India comes with 
the required expertise to help increase your revenue.
 Efficiency is the key to success in any healthcare setting! Your ability to innovate and improve 
patient experience while lowering costs and minimizing mistakes is critical to your success. 
To fulfil these objectives, it is critical to have a well-functioning medical billing system in place. With 
our DME billing services, we leverage our experience, expertise, and latest technology to ensure 
complete accuracy and competence.
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Policy Violations
When invoicing or payment for services is not in accordance with the written 
policy, it is considered a policy violation.
DME claims sent to Medicaid rather than Medicare or another primary 
insurance plan. Medicaid is considered the payer of last resort, so payment 
should be sought from other insurance first.
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Coding Errors
Errors in code are another major cause. The claim will be refused if 
your billing team submits medical documentation with different codes 
than the ones billed. Typical coding related challenges are –
 Using HCPCS codes incorrectly to drive a diagnostic related 
group (DRG)
 For trauma and fracture diagnosis codes, the seventh character is 
incorrectly applied
 Respiratory failure is misdiagnosed
 Using guidance tools incorrectly
 Inadequate documentation of devices, components, grafting 
materials, etc
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        Insufficient Documentation
When a provider’s documentation does not fully support the billed procedure 
code, it comes under the insufficient documentation error. Common DME 
claim documentation errors include:
 Medical Necessity – It is critical that the evidence demonstrates the 
treatments billed were medically necessary under Medicare’s coverage 
and payment policies.
 Use of Modifiers – Incorrectly employed modifiers for DME billing can 
result in claims being denied or rejected. Even a misplaced code can 
result in a claim denial.
 Verification of Patient Data – A common factor is a lack of patient data 
verification. Claims are denied by the CMS or the insurance provider if 
there are minor errors in names, or the way forms are filled out.
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Ways to Reduce DME Billing 
Errors
Quality control on services
 Verify the equipment or supplies provided are in 
accordance with documented policy.
 Verify the delivery of equipment or supplies is in line with 
beneficiary or representative signature.
 Verify that the completion of environmental modification is 
completed with beneficiary or representative signature
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Quality control on beneficiary 
records
 Confirm if beneficiary has other insurance as a major payer
 Determine a beneficiary identifier on each document.
 Double-check the documentation accurately so it reflects the type of DME 
and quantity delivered.
 Check the quantity of units billed as part of the claims processing quality 
control.
 Confirm the procedure or service code is correct, along with the service 
dates entered on the documentation.
 Ensure the claim’s number of units and product description match the 
documentation’s number of units and product description.
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Conclusion 
Offshore DME billing services have the required resources at disposal and are 
responsible for a knock in profits if they use incorrectly coded modifiers. 
Given the difficulties and complexities of DME billing, many providers opt for 
offshore DME billing companies. 
By offshoring their billing, they gain access to a team of highly trained coders 
and billers that are dedicated to delivering timely payments, minimized errors 
and increased collections.
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About us
Info Hub Services was founded in 2010, and is now one of the leading service 
providers of highly motivated, certified coders, and billers in the US medical 
billing industry.
Contact Us
India Address: 
Info Hub,
Sf No 558/2, Udayampalyam Rd, Nava India,
Coimbatore, Tamil Nadu 641028
US Address:
Info Hub,
1280, Patterson Ter,
Lake Mary.
Florida 32747