Find the things that insurance carriers think about Durable Medical Equipment (DME) and why that is important to your charging rehearsals. Clue, some may amaze you! However, all share one common necessity.
At the point when you consider DME products to lease or buy, sleep aids might be the last thing in your thoughts. Therefore, to the people who battle to get good sleep for medical problems, for example, progressing pressure point agony, bedsores, and sleep apnea, the privilege of DME thing could mean the distinction between awakening to torment or breathing challenges and feeling refreshed constantly. Instances of equipment that are considered billable in this classification incorporate such things as pressure-reducing beds, hospital beds, mattresses, and mattress overlays along with Continuous Positive Airway Pressure (CPAP) devices and their accessories. In the event that a patient needs one of these devices, check with your patient’s protection to see which things are accessible for coverage as per the patient’s medical services plan and clinical conclusion.
Several items which are used for regulating one’s health issues such as blood sugar (glucose) monitors and test strips are also considered billable. Such devices and tests are necessary to ensure that one’s glucose levels are in the normal range, if in case a lifestyle or medication adjustment is needed. Without studying the amount of glucose your patient’s body is absorbing, there can be dangerous consequences for example, too much glucose results in damage to the eyes, kidney, nerves, heart and more. In addition to eating well, exercising, and taking prescribed medications, insurance carriers understand blood sugar monitors and test strips play a major role in avoiding the more serious effects of unbalanced glucose levels.
For monitoring blood pressure, there are some restrictions. Insurance will cover certain devices for receiving hemodialysis or peritoneal dialysis and monitoring frequently noted low or high blood pressure while at home.Also, it is important to learn the limitations of coverage for each carrier as many devices are often deemed to be experimental and your claim may be rejected.
Patients who require assistance at home with walking, standing, sitting, or other mobility-related activity may be covered for the following items after a physician has deemed the equipment to be mandatory:
- Rollator / Walking Canes (other than white canes for the blind)
- Manual Wheelchairs
- Power Wheelchairs
- Patient Lifts
Since incontinence problems are already affecting millions of individuals in the U.S. alone,such patients with severe cases are prescribed a commode chair. These chairs are also suggested for patients who are considered to have high risk of fall. Patients need a commode chair to be used in the home to avoid accidents while trying to get to the bathroom are considered billable DME.
Devices for physical therapy
Patients injured,may need temporary therapy devices such as a Continuous Passive Motion (CPM) machine or traction equipment. These devices can be very important for a patient’s recovery. As such, the DME equipment is often covered with restrictions. As many therapeutic devices are considered to be experimental by insurance carriers, it is helpful to learn which pieces of equipment are covered by each individual carrier.
Medical Care at home
Home care may include specific devices that administer certain medications, enhance breathing, or remove fluids. Referring to the criteria and list of items covered for the patient’s insurance carrier getting details about which items may be reimbursed and for what purposes. Item typically covered for this level of care may include:
- Infusion Pumps and Supplies
- Nebulizers and it’s medication
- Oxygen Equipment and Accessories
- Suction Pumps
Accordingly, most items will meet all requirements for coverage with proper documentation. However, it is necessary for a patient to prove that a prescription item is a must for the patient’s quality of life by a licensed physician. If you are looking for coding, AR management for DME Medical billing, auditing, or DME medical billing services contact us. You can call us at +1 (866) 631-3108.