DME Billing Services

Insurance Verification is where it all begins. Submit a patient’s insurance information through the BillDME Provider Suite and you can get their coverage details immediately. There are situations, however, where the coverage details may not be accessible through the Provider Suite. That is where our Insurance Verification staff comes in. Our staff will do whatever is necessary to get the information necessary to get a patient’s coverage details. Once we have acquired the information, it is run through the Provider Suite algorithm and positive or negative results are returned. However, you have the final say in whether we move forward.

Once the verification process is completed and a patient is approved, we will need a signed Patient Agreement and prescription to move forward. These documents are received by our Billing Compliance staff. We go through every line of information on the Patient Agreement to verify accuracy and ensure that we have all we need to bill the patient’s insurance. We check diagnosis codes against the prescribed equipment and use knowledge we have gained through years of experience to make sure the claim has the best possible chance of being reimbursed based on the specific insurance company and the prescribed equipment.

The BillDME Fulfillment Services staff controls the shipment of equipment. You have options with how fulfillment will be handled for your account. The equipment can be sent to you or directly to the patient. If you’d like to have the equipment sent to you, the Provider Suite has built-in Inventory Management. You can set par and re-order limits and receive new shipments automatically as needed. Should you prefer to have the equipment shipped directly to the patient, we can send it out upon the receipt of a signed Patient Agreement.

Our Patient Care staff is our direct link to the patient. Should you choose to take advantage of our Patient Follow-Up services, they will contact the patient periodically thought their prescribed treatment. They answer any questions the patient has regarding the equipment, prescribed treatment or the billing process and ensure their overall satisfaction. Also, in the event that reimbursement is sent directly to the patient, our Patient Care staff makes certain that we collect the payment for the equipment and the services rendered.

Every insurance company is different. Some companies allow the submission of claims online, while others require that you mail a form. You need to bill certain equipment as rentals for some companies, while certain items need to be shipped and billed in over time for others. Depending on the company, allowed amounts differ, modifiers may be required, and some equipment is just plain denied. The fact is, there are a lot of factors that go into whether a claim is approved or denied. Our Billing staff knows how to get maximum reimbursement for the prescribed equipment and the services rendered.

Our Collections staff are the people who make sure that all of the work put into a claim to this point was worth it. If a line item on a claim is denied, they figure out why and work that claim until reimbursement is received. Put simply, they turn claims into money. They are also the department that collects data and analyzes trends that influence how we bill certain insurance companies for certain equipment in the future. Upon receipt of reimbursement, this is the also department that posts the payments so that you are able to view reports and stay up to date with the status of what has been billed and collected.

Our Provider Support staff is in charge of account management. They are our direct link to you and yours to us. Upon becoming a BillDME Provider, a member of our Provider Support staff will help you get acclimated to the Provider Suite and answer any questions you may have regarding the process. As you begin using the system, your Provider Support representative will monitor patients through every step of the process. They are the person who will ensure that everything is running smoothly and that you have a real person to assist you when necessary.