Home Medical Equipment (HME)

Ensuring accurate and timely submission of insurance claims, including reviewing and preparing claims before sending them to payers

Ensuring adherence to all applicable healthcare regulations, billing standards, and payer requirements to avoid denials and audits.

Managing the entry of orders for equipment, ensuring all necessary documentation is complete, and tracking the fulfillment of orders.

Confirming patient insurance coverage and benefits to ensure equipment costs will be covered by the payer.

Obtaining necessary prior authorizations for equipment and services from payers to avoid claim denials.

Identifying, addressing, and resubmitting denied claims to secure reimbursement for services rendered.

Monitoring outstanding claims and invoices, following up on unpaid or underpaid claims, and ensuring timely collections.

Recording payments from insurance payers and patients, reconciling accounts, and managing payment discrepancies.

Managing patient invoicing, handling patient questions regarding bills, and collecting payments for out-of-pocket expenses.

Providing detailed reports on claim statuses, revenue cycle performance, and key financial metrics to support business decision-making.