How to select the right revenue cycle partner: Three factors to consider
Posted on 16 Feb 2023
Important factors to consider while partnering with a revenue cycle vendor.

An increasing number of DME practices are turning to revenue cycle vendors to handle their collections. According to a study, 83% of healthcare organizations partner with one or more vendors to manage their revenue cycle. But not all RCM vendors are the same.

Several factors must be considered before signing on the dotted line. The ability to improve clean claim rates, workflow automation options, and depth of expertise in the DME billing space are key factors to consider.

Specialized expertise in the DME space

To achieve optimal reimbursement, it is important to work with a revenue cycle vendor who understands the nuances of DME billing and thorough knowledge of HCPCS Level 2 codes. The most common problem faced by DME billers is the difference in billing across insurers and DME product lines. This can lead to revenue slipping through the cracks. A vendor who has proven expertise in DME billing can optimize reimbursement and ensure compliance.

Streamlined prior authorization process

Obtaining prior authorization and ABNs ( Advance Beneficiary Notice) for DME supplies is crucial. The prior authorization process is tedious and may take weeks to obtain. Filling PA forms and following up with payers is a long drawn process. In some instances, patients drop out of treatment plans because of the complicated prior authorization process. To maximize reimbursement and cut back on administrative burden healthcare organizations must partner with RCM companies who utilize technology to automate the prior authorization process.

Meet financial performance and efficiency goals with analytics

The revenue cycle management vendor should collect and analyze vast volumes of data to make sustainable process improvements. Predictive intelligence and data analytics can reveal reimbursement opportunities, missed pockets of revenue, denial patterns and process inconsistencies.

Power your revenue cycle forward

SolvEdge is the trusted revenue cycle partner of hospitals, health systems, and ACOs. The breadth of experience within our walls has fueled the revenue growth of DME practices across the country. We bring to the table custom-built technology to accelerate financial performance and automate key processes. Our DME billing experts can put you on the path to
long-term success.

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