DME and Orthotic Supplies billing and accounts receivable
Soft Home Global works DME accounts receivable, denials, eligibility and prior authorization as a full time seat inside your own system, from $1,700 per seat per month. The denials below are the ones that cost dme and orthotic supplies practices the most, and they are what a seat is trained to attack first.
Durable medical equipment is documentation billing: the order, the face-to-face, the medical necessity and the delivery all have to exist before the claim does.
Where the money leaks in dme and orthotic supplies
These are the recurring denial reasons in this specialty. They are not exotic. They are the ordinary ones that go unworked because the person who could fix them is at the front desk answering a phone.
- Missing or non-compliant written order prior to delivery
- Face-to-face encounter not documented inside the required window
- Rental and purchase billed against the wrong cap or continued past it
- Missing modifiers identifying new, used, rented or replacement equipment
- Proof of delivery absent when the payer audits, turning a paid claim into a takeback
What a seat does about it
One trained person works your queue from the difficult end. Every call is logged with the payer reference number and the outcome, so an appeal can quote what was said rather than start again. Denials are categorised, which is how the same reason stops coming back next month. On Friday you get it in writing.
The roles that matter most in this specialty are AR calling and denials at $1,700, prior authorization at $1,900, and certified coding at $2,500.
Questions
What are the most common dme and orthotic supplies denials?
Missing or non-compliant written order prior to delivery. Face-to-face encounter not documented inside the required window. Rental and purchase billed against the wrong cap or continued past it.
Do you have people who know dme and orthotic supplies?
Not a bench of dme and orthotic supplies specialists sitting idle — we would rather say so. A seat is trained on your specialty, your payer mix and your system for about a week, and stays on your account rather than rotating.
What does it cost?
An AR caller working denials is $1,700 per seat per month. Prior authorization is $1,900. A certified coder is $2,500. Full time, US hours, one month minimum.
Next step
Put one seat on your dme and orthotic supplies AR
Twenty minutes is enough to work out whether the denials above are the ones costing you money. If they are not, I will say so.
Or write to ops@softhomeglobal.com