DME Medical Billing Services
Boost Your DME Business with Expert Billing
DME Medical Billing, Coding, Practice Management & RCM Solutions that boost profitability & improve patients’ experience.
Durable Medical Equipment (DME/DMEPOS) billing has its own rules, codes, and documentation requirements. Our certified billing experts help DME suppliers, HME companies, respiratory care providers, orthotics & prosthetics clinics, and home health equipment providers get paid faster while staying fully compliant.
For more than two decades, we’ve delivered customized medical billing, coding, and accounts receivable services to healthcare organizations across the United States. We combine people, process, and technology to reduce denials, speed up reimbursements, and improve cash flow.
Eligibility & Benefits Verification (E&B) – Real‑time checks for Medicare, Medicaid, and commercial payers; coverage, copays/coinsurance, deductibles, same/similar.
Order & Documentation Audit – Review face‑to‑face notes, Standard Written Order (SWO), Proof of Delivery (POD), medical necessity, and WOPD requirements prior to delivery.
Prior Authorization Management – PA submission and tracking for items on payer/CMS lists; proactive expiring PA alerts.
Accurate Coding & Modifiers – HCPCS Level II expertise (NU, RR, UE, RA, RB, KX, GA/GZ, LT/RT, EY, MS, KH/KI/KJ for capped rentals) with payer‑specific rules.
Clean Claim Submission – Electronic claims with attachment management; NCCI edits, same/similar checks, and frequency limits validated before submission.
AR & Denials Management – Timely follow‑ups on unpaid/underpaid claims; appeal packages for documentation‑related denials (e.g., same/similar, POD, CMN/SWO issues).
Patient Billing & Support – Transparent statements, payment plans, and inbound support for questions on rentals vs. purchase and recurring supplies.
Revenue Intelligence & Reporting – Month‑end performance dashboards: first‑pass rate, DSO, denial categories, rental aging, recurring resupply trends.
Compliance & Security – HIPAA‑compliant workflows, audit trails, and staff training aligned with CMS and payer policy updates.
Our DME Medical Billing Services include:
Leverage Our Expertise in Durable Medical Equipment (DME/DMEPOS)
We understand the nuances that cause most DME denials. Our team proactively checks the same/similar history, validates coverage criteria, confirms face‑to‑face and SWO/WOPD requirements, and ensures Proof of Delivery meets CMS standards. We also manage capped rental timelines and transitions to purchase when appropriate, so you never miss revenue.
Common DME categories we support:
Respiratory & Oxygen (CPAP/BiPAP, oxygen concentrators, nebulizers)
Mobility (standard/lightweight wheelchairs, walkers, canes, rollators)
Hospital Beds & Support Surfaces (semi‑electric/electric beds, pressure‑reducing surfaces)
Orthotics & Prosthetics (AFOs, knee braces, spinal orthoses, prosthetic devices)
Diabetic Supplies & Footwear
Bathroom Safety & Daily Living Aids
Example HCPCS billed frequently (illustrative): E0601 (CPAP), E1390 (oxygen concentrator), E0260 (hospital bed), K0001–K0004 (wheelchairs), A7030/A7031 (CPAP masks/cushions), L1902 (AFO), A5500 (diabetic shoes). Codes vary by payer and clinical documentation.
Why DME Providers Choose Us
Certified Coders (AAPC/AHIMA) and dedicated DME billing teams
98%+ clean claims with rigorous pre‑submission edits
24–48 hour claim turnaround and proactive AR follow‑up
US‑wide coverage and payer‑specific rule libraries
Transparent reporting with denial root‑cause analysis
DME billing scenarios we handle
Same/Similar denials (within reasonable useful lifetime)
Prior authorization on high‑risk items
KX/GA/GZ documentation and modifier usage
Capped rental (RR→NU transitions) and maintenance
Replacement due to loss/irreparable damage (RA/RB)
Proof of Delivery (POD) and signature compliance
Frequency/quantity limits for recurring supplies
Want to enhance the financial health of your DME business?
With years of DME billing experience, our team understands what stalls reimbursement—and how to fix it fast. Share a few details and we’ll tailor a plan to your inventory, patient volume, and payer mix.
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