Putting an End to Denials

Keeping your metrics balanced is a vital step that DME managers that are serious about keeping their records clean and current are not willing to skip. However, metrics are just one determining factor that let you know whether or not your DME management plan needs tweaking. This particular article was written with those who feel like their metrics may be a bit too far gone for DME management alone.

Anyone in management knows that it is near impossible to tackle every potential problem that you can run into in one swift move but you can secure your DME metrics by splitting up your project into smaller ones and managing them separately to assure that you can achieve your ultimate goals. The first step you should outline in your plan of action is what is a priority and just how important each priority is. This doesn’t have to be anything fancy—it can be a simple spreadsheet of metrics and project details that are numbered from more important to less important. Your priorities should be the projects that are the most beneficial and cost effective.

Minimizing the amount of denials you get is not only beneficial for your business—it lightens the workload around the workplace allowing you to be able to work on new projects without being strapped for cash. You can see just how effective your DME management plan is by keeping a record of the denials you receive over a period of time (one to two months is beneficial). The main idea behind this test period is to track the reason why so many denials are popping up and to tackle the reasons why it happens one by one.

The next step is to sort out each of the denials. Categorize them in a manner that is easy to read and analyze/present to your team. Think in terms of invoices sent to the wrong address, expired medical coverage or even invoice with the wrong payer information. Each of these instances are key reasons why many practices experience such high rates of denials. Knowing this information beforehand can pave the way for tighter strategies to ensure that these instances do not continue to happen in large numbers in the future.

One of the top things you can do to reduce the number of denials you get is to check special forms of healthcare such as Medicare. Medicare audits medical companies and failing these audits can mean high denials and of course, a burning hole in your pocket. Be sure to maintain records of everything related to your Medicare patients and products because they are subject to auditing at any given moment—the reason why you fail these specific audits may be different than what you find on your denial test so be sure to record it onto a separate spreadsheet.

Be sure to evaluate your findings with your billing team. This will ensure that everyone knows what is going on and each person can receive specified training to stop these denials in their tracks and get your medical practice back on track!