The process of attaining durable medical equipment has been simplified over the years. However, the challenges of documenting and executing its billing are still prevalent. There are many evident loopholes, be it the excessively long turnaround time in claim settlement or the incorrect entries in bills. These loopholes increase the possibility of fraudulent activities, which can badly affect your claim settlements and reimbursements.
Read on to discover more about DME billing frauds and know how you can carry out safe and secure DME billing.
What Is DME Billing Fraud?
No matter how noble an industry can be, some fraudulent players always try to fill their pockets with malpractices and cheating. These notorious companies bill medicare beneficiaries for specific equipment without justifying the need and, in some cases, do not even send the billed equipment to the patients.
In most cases, people overlook the small headers and footers where the information related to these products is mentioned. As a result, DME billing fraud is conducted where the deceitful companies end up making voluminous gains.
But, there are many ways to prevent these things from happening. All that is required from your end is a little bit of caution.
How To Scrutinize DME Bills to Find Irregularities?
There are many small things that can be checked off to ensure the authenticity of a medical bill. If an error is spotted, the same can be reported to the concerned authorities for appropriate measures:
- If your medical summary notice or explanation of benefits statement incorporates a charge for some equipment that you never ordered.
- If you were promised a free piece of equipment, but the same has been added to your overall bill.
- If your medical service provider sends equipment that you have not requested.
- If there are recurring amounts in payment cycles for a piece of equipment that has been removed from your prescription.
- If the equipment that you received is not identical to the product mentioned in the bill.
- If a manufacturer/supplier tries to reach out independently to seek your medical care number.
- If you get pressurized by your care provider to use a particular brand of equipment that has cheaper and more effective alternatives available.
All these scenarios are evident red flags, and if you unravel any of these in your bills, you must raise the alarm. Your report will be filed with the medicare officer to audit the documents for clarity and bogus inputs.
However, if you are too busy with your day-to-day activities to ensure that your bills are filled with correct values or your insurance claims have a quick turnaround time, the most pragmatic solution is to outsource your DME billing to a team of experts.
Medical Billing Solutions Nationwide is a pioneer in DME billing. It ensures that:
- Your claims are settled on time
- You receive the reimbursement without any hassle
- There are no discrepancies in the documents
- There are fewer denials
