Sunday, March 30, 2008

Medical Billing - DME Software Overview

In this installment, we are going to be starting a series on DME software for medical billing. This is probably the most popular software on the market because it is responsible for billing more claims than probably any other branch of the medical billing industry.

DME stands for Durable Medical Equipment. This is equipment that is either sold or rented to various Medicare, Medicaid, Blue Cross, Blue Shield and many private insurance companies including Prudential and Web MD. This equipment ranges from wheelchairs to concentrators. The amount of money involved in this industry is staggering. Because of this, there are many brands of software on the market that billers can use to bill these medical claims. Logistically, it would be impossible to review each piece of software. However, because there are so many similarities between the various brands, it is simple enough to go over the main parts that each software covers. This way you will have a decent idea of what is involved in billing DME claims.

The first part of DME software that we'll be going over in detail, in a future installment, are the setup options. These options allow the user of the software to customize it to their liking. Some of this is just cosmetic, such as screen appearance. But much of the setup also involves setting up the type of DME billing that they'll be doing, including designating what kind of provider the software will be billing for, whether it be single or multiple provider.

The next part of the DME software that we'll be going over is how patients, doctors, facilities, items and other things are setup in the system. There is a complex process involved in medical billing of claims that requires everything in the system to be pulled together when either printing out a paper claim or billing electronically. This is probably the most complex part of the whole system. This will be covered in great detail.

The third part of the DME software that we'll be going over is how billing itself is actually done, whether it be via paper or electronically. We'll cover the various ways to print or transmit a claim. We'll also cover the legalities involved with doing so, such as what needs to be signed and when.

The fourth part of the DME software that we'll be covering involves what they call add-ons. These are additional services that many billers use, such as purchase order processing and barcoding of products. This part of the system must also be integrated with the main part of the system so that it works correctly.

Finally, we'll cover some common problems that billers should be aware of with each part of the system. Medical billing, because of all the things that can be billed and all the medical regulations, is complex and confusing, even to the seasoned pro. To the beginner, it can be a total nightmare. Hopefully, after reading this series, you'll have a very clear understanding of the basics of medical billing and the DME software used to bill DME claims.

Michael Russell Your Independent guide to Medical Billing

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