Request a Demo
06/13/2022

Speed up Your Billing and Minimize Audit Risks

DME billing software | NikoHealth
dme billing hme billing

Following the recent announcement by the Centers for Medicare & Medicaid Services (CMS), starting with claims with a date of service on and after 01/01/2023 will drop the need for certificates of medical necessity (CMNs) and DME information forms (DIFs).

So, what does this mean for DME suppliers? Suppliers can minimize losses and lower administrative costs associated with obtaining these antiquated documentation requirements. Without the need to get CMNs and DIFs, DME suppliers can increase cash flows, improve service delivery, and reduce the risk of chargebacks.

Eliminating requirements for these certificates and DME forms is a dream come true for durable medical equipment suppliers.

Suppliers will not have to chase around doctors to fill out forms or endure denials and audits because of missing information. However, before January 1, 2023, you still have to submit the CMNs and DIFs.

Benefits of the CMS Removal of CMNs and DIFs

1. Reduce Administrative Burden

CMS continues to roll out reforms to reduce the administrative burden affecting the DME/HME industry. By eliminating the need to fill medical necessity forms, you don’t have to worry about waiting for doctors to sign forms and ink their signatures. Usually, you need a signed order and an electronic CMN or DIF to submit with a claim and documentation follow-up will reduce drastically by implementing the new CMS directive.

Reduce administrative burden

Previously, audit reports could show missing documentation, something that may attract charge paybacks or even worse litigation. If CMNs and DIFs do not provide sufficient information about claims, it leads to automatic denial. Missing dates, signatures, or miscoded units create audit risks, which may lead to revenue loss. When the new CMS guidelines take effect, you’ll be able to submit your claims without enduring the tedious and expensive process of obtaining the required forms and certifications.

2. Fast and Efficient Billing

Fast and Efficient Billing | NikoHealth

Heavy documentation remains the primary hurdle to seamless DME billing operations. With many documents to fill and verify, suppliers and clinicians can wrongly bill payers, leading to denials that prolong the revenue cycle. Removal of CMNs and DIFs is a major boost to the billing process as it implies a reduction of documents one has to verify before submitting a claim.

When you bill according to coverage determinations and CMS requirements, you’re likely to avoid denials and payment delays. Having eliminated the need for equipment necessity certifications, CMS has made it easier for you to bill claims faster and accurately. Remember until January 1, 2023, you still have to submit the correct certifications.

3. Minimize Audit Risks

Staying at the top of your game with DME compliance is important in speeding up payments and reducing audit risks. Post-payment auditing can occur months or years after submitting claims. Whenever physicians are unwilling or cannot produce the much-needed documentation on time, it can cause errors that cause auditing. 

reduce audit risks

Sometimes, the documentation released by the physicians does not match the data in the submitted claims. As a DME/HME supplier, missing or incorrect information can expose your business to auditing risks.

4. Reduce Losses and Increase Profits

HME DME billing software | NikoHealth

For HME/DME suppliers, streamlining billing results in increased profits and improved service delivery. However, improper DME billing causes a decrease in collections, audit risks, and a surge in denials. Through the elimination of the CMNs and DIFs, providers will now enjoy faster claim submission and resolution.

Since suppliers will have a few documents to chase and obtain from referrals, they can submit claims easily and receive payments quickly.

Billing durable medical equipment can be complicated and time-consuming. With the right dme billing software provider – NikoHealth – can streamline processes and integrate them into one simple and intuitive solution.

Ashley Banks

    Maybe later
    mail
    Newsletters

    Do you have anything to share with us? Leave a comment

    I agree with NikoHealth's Privacy Policy.

    Comments

    M.A.
    06.15.2022

    This will bring big relief to all of us. We won’t need to chase doctors anymore and delay all billing decisions. And, of course, post-payment audit risks will be reduced significantly.

    Related Articles

    Blog
    12/02/2022
    4 Secrets You Need to Succeed in the DME Industry
    The durable medical equipment supply industry is growing rapidly. But success in this field has been elusive for many DME/HME businesses because making it in this sector requires in-depth industry knowledge. Having been in the market for decades, the information we share about how to succeed in the DME industry is based on our struggles and successes.
    How to succeed in the DME industry
    Blog
    12/01/2022
    Why the 7-Day Business Delivery Model Isn’t Working Anymore
    Online shopping trends now show that speed of delivery is a significant consideration for up to 77% of shoppers. So, the 5-7 business day delivery is no longer feasible. In this article, we explain how to shorten the delivery process and period for your home care business.
    Why the 7-Day Business Delivery Model Isn’t Working Anymore
    Blog
    10/13/2022
    The Covid-19 Aftermath: Why Automation Is Crucial  for HME/DME Business 
    The coronavirus pandemic is a wake-up call to governments and healthcare systems regarding emergency preparedness. What can business in the healthcare industry do from his side?
    The Covid-19 Aftermath: Why Automation Is Crucial for HME/DME Business