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June 29, 2022

DME Billing: Outsource Versus Manage the Billing Process Internally

DME Billing | NikoHealth
billing dme billing hme billing outsourcing

The medical billing outsourcing market is on the surge. According to the research by Reportlinker, it is expected to grow from $2.17 billion in 2021 and reach 20 billion by 2026 with an annual growth rate (CAGR) of 11.5%.

The reason for this rise? Companies are resuming their operations, adapting faster than ever before after COVID-19 impacted all aspects, including social distancing practices such as remote working or even closure of commercial activities leading up until the early 2020s when containment measures were put into place later, allowing some flexibility again but at a more economical cost which resulted in tough challenges faced during the recovery period. 

What are those challenges, and why do DME providers look to outsource DME billing and revenue cycle processes? Let us have a closer look.

1. Labor Shortage

The high demand for labor has caused significant challenges in recent years. With businesses of all types fighting to hire new staff, retaining employees is more critical than ever! Durable medical equipment providers are not strangers when it comes to hiring and training people; they know how complicated this industry can be with its constantly changing requirements. Many DME suppliers simply don’t have enough workers available so that everything gets done on time without delays or disruptions, especially regarding DME billing and revenue cycle management.

2. Inefficient Systems and Processes

Relying on inefficient processes including manual tasks, paper and disparate systems can not only overcomplicate operations but leads to cumbersome and error-prone billing and revenue cycle management processes. In many cases these inefficiencies require DME providers to add staffing to meet the workload demands which in turn increases overhead and reduces profitability.

As a result, they need to invest more time and effort into the back-office work instead of focusing on client service and strategic development.

3. Lack of Knowledge

Commercial and government payers don’t make billing DME-related claims easy. With varying payer requirements including documentation, compliance and EDI transmission protocols – billing DME claims can be quite confusing. From prior authorizations, HCPCS and modifier combinations to state Medicaid waivers, how do providers maintain the most UpToDate knowledge base? It’s no surprise that many claims contain errors.

Because of that, companies may decide to outsource their billing and revenue cycle processes. Bottom line: Improving your revenue cycle process improves the profitability of your business.

The decision to outsource may provide value, however starting with improving the front-end operations to help bridge your operational workflow gaps will prevent rejections and denials, reduce time-consuming follow-ups on accounts receivable and eliminate labor-intensive tasks.

Explore the right systems to bring all your work into one place where waste is eliminated, resulting in cleaner claims while decreasing the time and cost of getting paid.

Take control of your DME operations while reducing operational costs for claims management and speed up collections with the latest DME software to help with:

  • Patient and Order Management
  • Insurance Eligibility and Verification
  • Simplified Patient Collections
  • Inventory and Delivery

Are you ready for the next step and stand out from your competition? Discover your opportunities for growth with NikoHealth – an innovative software solution created for HME/DME professionals that connects your operations and improves your bottom line and DME billing.

Ashley Banks

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