DME & Orthotics Billing
DME & Orthotics Billing from Soft Home Global costs $1,800 per seat per month. That is one full time trained person, forty hours a week, working United States business hours inside your own system. One seat, one month, cancel any time.
A DME claim is decided before the item leaves the shelf. The order has to be signed and dated by the treating clinician, the chart notes have to support the item ordered, and the delivery has to be proved afterwards. When nobody owns that paperwork, items ship on faith, denials arrive weeks later with the appeal window already running, and rental months keep billing with nobody counting them.
What the seat actually does
- Intake worked before anything ships: benefits checked for the item, whether the plan needs authorization confirmed, and every document that order will need listed against it.
- The signed, dated order chased back from the referring office and checked for the clinician's own signature and date before delivery. The seat cannot supply or accept a backdated one.
- Authorization filed with the supporting notes attached where the plan calls for one, then chased by phone until there is a decision and a reference number, not a pending status.
- Proof of delivery chased back from the driver or shipper, checked against the order for item, quantity and date, and filed where the claim can reach it before it goes out.
- Resupply and rental months tracked on a calendar, patients called ahead of each cycle to confirm the supplies are needed, and billing stopped as soon as a pickup is reported.
- Records requests and denials worked as one packet: order, notes and delivery proof rebuilt together, the appeal drafted for your billing lead to approve, and the outcome logged.
What it costs
$1,800
Per seat, per month, in US dollars. Full time, forty hours a week, on US hours — not per hour, not per claim, and never a share of your collections.
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The denial codes this seat works
1 codes, grouped the way the queue is worked rather than by number. Each one links to what causes it, the order to work it, and how to stop it recurring.
Worked by being fixed in credentialing, not on the claim
- M115 — Non-contract supplierA DMEPOS competitive bidding denial: for this item, in this area, Medicare pays only suppliers holding a contract, and this claim came from one that does not.
Working a denied claim costs $57.23 per denied claim in administrative time (source) and about about 90% of initially denied claims are eventually paid. The reason they sit is almost never that nobody knows how. It is that nobody has the hours.
How a seat starts
You issue one named login. We sign the Business Associate Agreement before it is used. We agree the numbers you will judge the seat on, which you pick and you measure. Then we train for about a week on your workflow and the seat starts. Every Friday you get a written report of what was done, what the numbers were, and what went wrong.
Questions
How much does dme & orthotics billing cost?
$1,800 per seat per month. That is a full time person, forty hours a week, working United States business hours. Not per hour, not per claim, and not a percentage of what you collect.
Is there a minimum contract?
One seat for one month, cancellable with thirty days notice. There is no annual lock-in.
Do we have to change systems?
No. The work happens inside whatever you already use, through a named login you issue. We do not sell software and we do not route your data through anything of ours.
How quickly can a seat start?
About a week from the agreement, which covers training on your workflow, your payer mix and your system. You are not charged extra for that week.
Can the seat get the ordering clinician to sign?
No. The seat cannot sign an order, date it, or change a word of a clinical note. That has to come from the treating clinician's own hand, and a signature obtained any other way is worse than a missing one. What it can do is make the ask easy and repeated: one clear request naming exactly what is missing, sent to the referring office, followed up by phone, logged with who was spoken to and when. Orders still stuck after the second follow-up go on a weekly list for you, because at that point it is a relationship between two practices and only you can make that call.
Who is responsible for how the item is coded and billed?
Your credentialed coder or billing lead. The seat prepares the claim and checks it against what the order and the delivery record actually say, then flags it when the three do not agree: an item billed that is not the item ordered, a quantity that does not match the delivery ticket, a modifier the documentation does not support. Those go back to you with the discrepancy named. The seat does not pick the final code or settle the modifier question on its own, because that responsibility has to sit with a person your practice can hold accountable for it.
What about fitting, casting and handing the item to the patient?
Not this seat, and not any offshore seat. Anything that needs someone in the room, including measuring, casting, fitting, adjusting or taking a signature at the door, stays with your staff or your delivery contractor. The seat works either side of that moment. It makes sure the documentation is in place before the item goes out, then chases the signed delivery record back, checks it against the order, and files it where the claim can reach it.
How does the seat work inside our systems?
Through your own software, on a named user account you create with permissions you set, on your hours. Nothing is copied into a separate system on our side and no patient information is kept on local machines. Every action shows in your own audit trail under that person's name, which is also how you supervise the work. We hold no SOC 2 or ISO certification, and there is no such thing as a HIPAA certification for anyone to hold. What we will do is work to the access rules, VPN and device conditions your IT sets, and sign your business associate agreement.
What does it cost, and is it worth it at our volume?
1,800 US dollars per seat per month for one full-time person, paid up front, one month minimum, thirty days' notice either way. Whether it pays depends on volume. If DME is a steady stream, with orders arriving daily, resupply patients on the books and rental clocks running, one person has more than enough to hold. If you ship a handful of items a month as a sideline to a clinic, a full seat is more work than you have, and we would rather say that than fill a seat you cancel in six weeks.
Next step
Try one dme & orthotics billing seat for a month
$1,800 for the month. If it does not earn its keep, cancel it. Twenty minutes on a call is enough to tell whether it fits.
Or write to ops@softhomeglobal.com