Services
How can we help you?
PRE BILLING SERVICES
Order Entry Eligibility Verification Prior Authorization Doctor Office Follow Up Order Confirmation Delivery Scheduling
POST BILLING SERVICES
Denial Management Payment Posting AR Follow up Customer Service
ADDITIONAL ACTIVITIES
CPAP User Compliance tracking Patient Collections Re-supply processing Fax / documentation indexing and management support
Clients We Worked With
We Care Your Billings
You Care Your Patient
RCM Services | Coding Services | A/R Management Services
We provide end-to-end RCM solutions tailored to our client’s needs along with provider and payer solutions both. Durable Medical Equipment (DME) provides therapeutic benefits to a patient in need because of certain medical conditions and/or illnesses. DME must be found medically necessary, requires a prescription and should be authorized in advance, before it is eligible for coverage. Thus DME billing is fairly different, and more complex, from other types of medical billing and coding. It requires specialized, in-depth knowledge of all HCPCS Level II codes and the overall DME reimbursement process.
OUR COMPLETE DURABLE MEDICAL EQUIPMENT (DME) BILLING
PRE BILLING SERVICES
- Order Entry
- Eligibility Verification
- Prior Authorization
- Doctor Office Follow Up
- Order Confirmation
- Delivery Scheduling
POST BILLING SERVICES
- Denial Management
- Payment Posting
- AR Follow up
- Customer Service
ADDITIONAL ACTIVITIES
- CPAP User Compliance tracking
- Patient Collections
- Re-supply processing
- Fax / documentation indexing and management support
Rental timelines and billing cycle
Claim Coding: Rental vs. Purchase
- Rental Claims
Use HCPCS code for the item plus the RR modifier to denote rental. Include the start and end dates of rental period, and bill monthly based on payer rules. - Purchase Claims
Use the same HCPCS code without the RR modifier. Include documentation that supports medical necessity and purchase justification. Bill as a one-time claim.
Each payer may have specific policies, so always verify with their guidelines. Want this turned into a coding cheat sheet next?
Billing Requirements for DME
- Prescription & Medical Necessity
Must have a valid physician’s order stating why the equipment is needed. - Correct Coding
Use accurate HCPCS codes and necessary modifiers (e.g., RR for rental). - Coverage Verification
Confirm patient’s insurance covers the equipment type and billing method. - Documentation
Include usage details, rental duration (if applicable), and supporting clinical notes. - Supplier Enrollment
Billing entity must be enrolled and credentialed with payer programs (e.g., Medicare). - Timely Filing
Claims must be submitted within the payer’s allowed timeframe to avoid denials.
Timely Submission Tips
- Submit Claims Promptly
Send claims as soon as services are provided or equipment is delivered. Most payers have strict filing deadlines (e.g., Medicare: within 12 months of service). - Follow Billing Cycles for Rentals
For rentals, bill monthly according to the payer’s schedule—usually from the delivery date forward. - Confirm Delivery Before Billing
Never bill before the DME is delivered and usage is verified—include proof if required. - Track Timely Filing Limits
Different payers have different timeframes—stay updated to avoid denials. - Batch Submissions Smartly
Submitting multiple claims at once may save time—but don’t delay submission to batch unnecessarily.
Our experienced billing and coding professionals specialize in navigating the complex world of Durable Medical Equipment (DME) claims. From initial patient intake to final reimbursement, we streamline every phase of the revenue cycle to ensure accuracy, compliance, and maximized returns.
- Eligibility Verification & Prior Authorization
- Patient Demographics Entry
- Order Entry
- HCPCS Level II Coding & Code Modifiers
- Claims Submission
- Payment Posting
- Accounts Receivable & Denial Management
- Credit Balance Resolution
DME billing experts commonly handle claims for high-value equipment that requires precise coding and documentation. These include items like hospital beds, wheelchairs, oxygen delivery systems, CPAP machines, patient lifts, and power mobility devices. Managing these claims demands detailed knowledge of payer rules, modifiers, and compliance standards to ensure maximum reimbursement with minimal denial risk.
- Bathroom Equipment
- Canes, crutches, walkers, wheel chairs, knee walkers
- Communication and Speech Generating Devices
- Dressing supplies (for treatment of wounds)
- Hospital beds and accessories
- Nutritional supplies, incontinence supplies, feeding supplies and diabetic supplies etc
- Infusion Equipment and Supplies
- Other Miscellaneous Equipment (such as breast pumps)
- Oxygen and respiratory equipment like CPAP, nebulizers and oxygen concentrators
- Patient Lifts and Standing Frames
- Pneumatic Compressors and Appliances
- DMEPOS
Get In Touch With Us!
Phone
+1917605083316
info@vconnectglobal.in
Address
India Office
- EN-35, 5th Floor, Walzen Building, Salt Lake, Sector-V, Kolkata-700091
USA Office
- 167 Madison Avenue, Suit 205, New York, NY 10016, United States
