Review the Item and the Supporting Records
An equipment description alone may not provide the detail needed to prepare a claim. The billing workflow should identify the product, relevant order, service date and documentation available for the payer's requirements.
Native RCM helps organize these records and flag missing information. Clinical need and order accuracy remain with the responsible healthcare professionals; supplier records must reflect what was actually provided.
DME Billing Support Areas
- Coverage and benefit verification for the item category.
- Authorization tracking where required.
- Review of order and supplier account information.
- Coordination of delivery records and dates for billing.
- Review of rental, purchase or recurring supply claim details as scoped.
- Preparation and tracking of supplier claims.
- Payment posting, denial investigation and insurance AR follow-up.
Original Medicare DME claims for Wyoming fall within DME MAC Jurisdiction D. Other insurance products and payer arrangements can use different processes, which must be reviewed for the specific account.
Keep Rental and Recurring Accounts Organized
An equipment account may involve several billing periods rather than one delivery and one claim. The process needs to reflect changes, returns, replacements and the supporting records relevant to continued billing.
We discuss how your inventory and billing systems communicate those events. The aim is to help staff identify which accounts are ready to bill and which need supplier or payer clarification.
Investigate Denials Using the Supplier Record
DME denials may involve documentation, coverage, item details or account status. We review the payer's stated reason and the available order and delivery history before deciding on a supported correction or appeal route.
Denial management and AR follow-up can help keep the resulting action and payer response in a clear account history.
DME Billing Questions
Can you support rental equipment accounts
Yes. Rental account support can be assessed using your product categories, payer requirements and records of delivery, continued use and account changes.
Do you obtain or create clinical orders
No. Orders and clinical documentation must come from the appropriate authorized provider. Native RCM coordinates the administrative records needed for billing.
Can you support commercial insurance as well as Medicare
Yes. The service scope can cover your payer mix after the applicable supplier workflows and submission routes are reviewed.
Review Your Supplier Billing Process
Contact Native RCM to discuss DME billing services for your Wyoming organization.