Why DME Prior Authorizations Becomes so Critical for your Business
Last year, the CMS announced its plan to add new 12 HCPCS codes in the month of July to the national prior authorization master list program. These kind of implementations are a two-pronged process, once an item is on the Master List, CMS can place it under the required list of prior authorization any time. Also, items that are potentially subject to prior authorization get updated in the register which includes items that have a higher cost and have the tendency of not receiving proper payments!
Settling your score with prior authorization, collecting all the documents that prove the medical necessity is a critical need for your everyday business. Also, finding someone that helps you improve your abilities in dealing with inventories better, reduce your DSO’s, sounds pleasant isn’t it! With the rising number of unemployment challenges all across, finding a team that can help you with solutions or your every DME prior authorization, getting it approved on time, scheduling the delivery on time, can be crazy!
Choosing the right resource: One of the biggest changes that you can do as a provider is looking for experienced staff handling all your front and back-office needs with very day revenue cycle management. The rate of improper payments especially in the segment of Power Mobility Devices is as high as 43%. If you do not find the right team, you can head for dire consequences. Also, management of compliance all across is a critical need for managing payer relationships.
Managing your front office lays the foundation: Are you done with your eligibility checks? Do you have all the documents in place from the referring physician? Are you all set to schedule the delivery of the item to the patient and have created all with patient demographics? You must have answers to all these questions and set the perfect foundation for cleaner claims and quicker reimbursement. Finding a team that can handle all your practice management needs will be extremely important.
To conclude, you must look for specialized intervention that can help you with better standards and a chance to reduce your operational costs. A reliable team that understands the changing regulations and the best way to work around denials, quickening the DME prior authorization process first will be a full-service approach that needs experience and excellence. If you find someone to do that for you, its great!