DVT, widely known as Deep Vein Thrombosis is a condition where blood clots/clot form in a deep vein located in the thighs and legs. This is a very serious condition because it can very easily break loose and move to the lungs. The patient is likely to develop anxiety, nervousness, unexpected shortness of breath, dizziness, coughing of blood, fainting, a fast heart rate or rapid breathing. For this reason, compression devices should be used appropriately to prevent this condition.
The compression devices consist of inflatable equipment for the leg and a pneumatic pump that fills it with compressed air. Many surgeons leverage DVT prevention either during and/or after surgery via using pneumatic compression devices and sleeves. These DVT prevention devices can be supplied by a durable medical equipment (DME) supplier. The DME supplier, in many cases, will provide the compression devices and sleeves for patients for which the physicians prescribe these devices for preventing DVT. Consistent billing procedures are highly important for the DME supplier. Should claims fail to be submitted appropriately it means that the DME supplier will not get paid. Note that there is a lot that revolves around DVT that must be accounted for effectively and accurately.
The medical billing service provider ensures that all necessary paperwork and forms are completed. They also ensure that the details entered are approved before entering them into the medical billing software. That includes the information of the patient, sex, insurance details, the medical billing codes, address, and date of birth, payments, and so forth. All the information that should be submitted to the insurance company is collected. The billing specialist also communicates with healthcare providers, DME suppliers and their representatives routinely to clarify and obtain claims and the payment information. The specialist keeps in touch with Healthcare providers, DME staff members, patients, and the insurance companies.
The Billing Company works with the DME to confirm their policies related to medical billing. The billing specialist goes ahead to post and collect patient and insurance payments, billing patients as per the policies established by the DME, following up on unpaid claims and denied claims, posting the patients and insurance payments, answering patient questions in regards to charges, and also preparing claim appeals. The specialist has to be detail oriented, understand the insurance process, be familiar with medical billing guidelines, understand the DVT medical terminologies and compression devices used, understand the coding, be excellent at data entry, be trustworthy, and have excellent multi-tasking skills. Consistency in billing performance of a team is very important to achieve the desired results. This requires a team that can performance consistently and learn continuously.
The moment a patient visits a doctor, they are evaluated and the observed conditions and treatment written down. The physician and DME supplier complete the appropriate paper work for the Medical Billing team. The details provided by the physician and DME supplier include the appropriate device and/or Soft goods provided to the patient and the patient diagnosis codes. The codes are then fed to the patient encounter form or a superbill. The medical billing specialist then transfers the information into the medical billing software. Then, claims are sent to the insurance company. Depending on the insurance company and procedure, many of the claims might need to be sent via paper with a prior authorization completed. Should the claim be rejected, the specialist follows up and tries to find out why it was rejected. There are times where an appeal has to be written and accompanied by supporting details to the insurance company. If you notice, this is so much work that must be handled with utmost caution and done by a professional.
Given that intermittent pneumatic compression is one of the highest rated methods of DVT, there are many systems that are used for different compression sequences and techniques through it. For the right choices to be made for the optimum protection of the patients, the provider needs to choose a system/company related to DVT prevention. DME suppliers are busy acquiring clients, investing in new technology, supplying and serving their clients for which the time, resources and expert team needed to for appropriate Medical Billing can be a distraction. This distraction can lead to the demise of a business of the DME supplier. Since Medical billing related to DME and DVT prevention is a very specialized area, identifying a medical billing company that can develop customized processes is very important for the DME company to achieve optimal results.