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Thursday, May 23, 2024

Top HME Billing Strategies to Increase Revenue

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Recent changes in the US healthcare system have presented both providers and patients with a slew of new challenges. Many aspects of healthcare reform are more time-consuming, such as the implementation of value-based compensation models. Furthermore, frequent changes in DME and HME billing rules and regulations can result in revenue losses for providers all over the country.

According to a Commonwealth Fund survey, medical providers in the United States lose about $125 billion in uncollected revenue each year. This is primarily due to the lack of understanding of DME and HME billing rules and regulations, as well as billing errors. Between 2009 and 2018, deductible costs increased by 150%, and only 62% of adults are somewhat confident in their ability to afford health care.

How do you get past the barrier?

Although the data paints a bleak picture of the industry’s financial health, there are reasons for healthcare providers to be optimistic. Medical practices are becoming more proactive in their HME medical billing procedures to reduce practice financial issues and compliance risks.

Following are some steps your medical practice can take to become more proactive in HME billing procedures:

Create an accurate process of collection

All providers need a process of collection to ensure the financial health of their practice. Establishing a step-by-step approach refines procedures for all stakeholders and can considerably enhance the revenue cycle by ensuring patients are fully and accuratly informed.

Manage claims correctly

Roughly 80% of all health bills contain mistakes. Mainly because insurance companies are so rigorous about the correct HME billing and coding, they are almost certainly being rejected.

The procedure of:

  • Submission
  • Rejection
  • Editing
  • Resubmission

 could take weeks, which means that providers must wait months for their services to be paid for. In terms of time and effort to revisit and resubmit, claims must be correct and complete for the first time.

Minimize coding errors

Medical coders use standardized codes to describe the procedures taken in the claim, facilitating understanding and processing. The following codes can be classified by:

  • HCPCS Level II systems
  • ICD-10-CM
  • CPT

Manage claims denied or dismissed

Checking for mistakes can help reduce the number of refusals and denials, but when they happen, ensure that they are dealt with as quickly as possible. Keep in touch with the payer’s representative.

They can help resolve the original claim problems and provide updates on current claims while processing them. These can all help speed up the process of the requested editing and reduce the time required to appeal and re-file claims.


If you wish to maximize efficiency and revenues, physician practices should adapt to the changing health landscape. Practices can identify areas of problem and develop new ways of dealing with them by monitoring the performance and staying up-to-date on the latest healthcare regulations.

The following steps should be taken to ensure maximum efficiency and precision by the medical practices:

  • Maintain AR’s track
  • Stay up to date
  • Determine the problems of the accounts

Understand When to Outsource

Medical practices should be more focused on

  • Patients
  • current trends in medicine
  • Proper management of personnel

The latest coding standards, insurance companies, and HME billing regulations must also be kept up to date. The billing details could be categorized in following segments

  • Refusals
  • Denials
  • Deposits not paid

In response to ever-increasing rules and regulations, many practices have outsourced their DME/HME billing and coding to third-party specialists. This is an economic way for many to boost revenue and regain control over HME billing.

Sunknowledge: The HME Billing Experts

We not only ensure 99.9% precision but also have the highest productivity metrics in the domain. Our AR monitoring experts help you to collect 80% of claims that are pending since 90 days or more, resulting in efficient cash flow for all our clients.

Unlike any other RCM provider in the healthcare industry, our team can provide remote assistance during pandemics. When most of the other RCM suppliers are facing difficulty fulfilling their production mandates, we continue to maintain the highest levels of productivity in the industry. Due to our dedicated resources, we offer unparalleled and continuous 24×7 assistance to each client in the DME/HME service provider.


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