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DME billing

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Pay_My_Claims:
I have gotten a couple of emails from members regarding my reference to DME billing. I have done billing for other specialties, but right now my full time job is DME billing and AR. DME is a very broad specialty area. It can range from shoes to high end mobility equipment. I am focusing my billing service on customized DME suppliers. The revenue is very good. The company I work for can see weekly receipts ranging from 0-100,000. On average he brings in about 50k a week. Just one chair can be billed out at $30.000 and bring in around 21,500. We have a client paying out of pocket of $30,000. Imagine your payment!!  So know you want to know the bad part. Well for high-end rehab, there is a lot of documentation required, Medicare has strict guidelines, and you don't have a superbill to work from Yes thats correct, the physician will fax over a RX for the client, the ATS will see him/her they go to a seating clinic, have a face to face, we obtain medical records, a LMN/CMN, send off for Admc approval and oh yeah you have to code each item along with the correct modifiers, and it is usually more than one modifier required. EX: E0630RRKIKX would be used to show a hoyerlift  this is the  2nd or 3rd  month rental and all required documentation is on file. Its not difficult to do, but it does require proper training.

jcbilling:
If you don't mind me asking...what kind of percentage do you charge your DME clients? Considering the paperwork & the high dollar amount...I've thought about marketing more to DME Suppliers, but not really sure what rate is reasonable.

Thanks,
Charity

Pay_My_Claims:
more of a flat fee billing. 5% for any claims under 10k, flat fee of 1000 for claims over 10k.

Pay_My_Claims:
This if for high end custom Rehab billing. Other DME billing carries different fees. Even with custom Rehab if they only have me doing the billing portion, the fee is altered for that. It's higher because of the level of required documentation needed in order to bill for DME. For a provider that brings in 100k a week, he isn't going to pay anyone 5% There has to be some balance.

jcbilling:
When you say 5% for 10K, is that for a week of billing or a month? From your example given on 100K, it sounds like a month - just wanted to make sure I understood.

I currently bill for breast prosthesis and charge 4% - probably too low. But I've gotten experience and was just starting in the billing field - so both me & my client were happy!

However, now that I know a little bit more, it's nice to make a decent profit on hard work :)

~ Charity

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