REASONS FOR REVENUE LEAKAGES IN DURABLE MEDICAL EQUIPMENT (DME) BILLING
Top reasons why revenue leakages happen in DME billing
Denial of claims: 20% of all revenue loss is due to denial of claims.
Claims can majorly be denied if:
§ Demographic Information of the patient is incomplete.
§ Information is missing or invalid.
§ Medical Necessity of DME usage is not clearly
§ CPT code, Modifier, PIN, or NPI is incorrect or
§ Duplicate claim or service is found.
Inaccurate codes: Another common reason for revenue leakage is incorrect
coding of accessories or equipment. Only when the DME biller identifies the
right HCPCS level II codes and sends over the claim with authorization
paperwork, the insurance company will pay the claim.