A lot of nightmare stories with prior authorization for durable medical equipment (DME) items and services center around with patients not receiving the prescribed medication as being prescribed, and with providers not getting paid for the services rendered! The master list of DMEPOS items as created by the CMS with requirements of prior authorization gets changed overtimes.

Changing regulations, issues with understanding the adjudication priorities, having the right provisions in place with practice management is surely a challenge.  Also, finding a competent team handling all your DME prior authorization needs has got to do a lot with careful strategic planning.

A team that knows about PHI

Managing compliance with consistency, offering to stand out support with doing all the heavy lifting works, well, that’s what you have been looking for as a supplier! It is all about finding a quality team able to handle all your worries with eligibility verifications, working around a way to find a cure to your time getting spent on DME prior authorization, getting all the documents collected from the physician office.

If your task-specific activities with pre-billing are settled, you have set the right benchmark for reducing your denials, improving your collections in the long run. Also, the team knows what it means with patient information accountability and HIPAA compliance with their activities in revenue cycle management.

How to set the right tone in DME prior authorization

Creating the sales order, entering patient details, finding all the documents in time before scheduling the delivery is critical. Right from initiating the PA request as per the protocols, checking the patient’s eligibility, maintaining effective payer communication, checking of the auth-status, follow-ups, providing of additional documents, and updating the outcome of the authorization details, you have the find specialized intervention!

To conclude, it will always be pertinent to make sure that you have the right provisions in place with your DME prior authorization process. A reliable operational arm or someone with strong references as a complete RCM destination will add huge value. Superior standards of communication, ability to offer expert guidance is what makes all the difference in you making more money as a durable medical equipment (DME) supplier.