Documents required for DME Billing

[dganeshd]

Hi Everyone,

I am new to DME billing process, can anyone tell me what are all the documents the biller should have / require to initiate or bill DME to the insurance companies.

[Michele]

That is a pretty vague question but I will try to answer.  The biller does not have to have documentation, it has to be in the patient's chart.  I believe in general the patient's chart should include a copy of the ordering provider's rx, and any advanced beneficiary notice if required.  Basically the documentation showing the medical necessity for the item.

[dganeshd]

Hi Michele, Thanks for your prompt response.  the DME supplies company has setup the business newly and don't know which all the documents to be shared with the billing team. I would like to know which all the documents / info should be requested to / or provided by DME supplies to billing team to do the billing process.

Thanks Again.

[Michele]

Usually the billing team only needs the information needed to complete the billing.  They don't need all of the documentation.  Just the name of the ordering physician, the diagnosis, and the items purchased.

[medwave]

DME billing can be challenging and confusing, especially if your team is not up to date with the latest policies and procedures of the payor. It demands an in-depth knowledge of reimbursement standards of both Medicare and Medicaid, as well as commercial, private insurance plans. DME billing also requires a non-stop commitment to quality and keeping up to date with all the changes which occur within reimbursement guidelines and coding and documentation musts.