The DME market is being reshaped by new regulations and retrospective claim reviews. The failure of the industry has been on software developers producing applications that served one purpose, “transmit a claim” for payment to Medicare. Yes, this was an important feature to have in your software and you’d be hard pressed to find a solution today that can’t transmit a claim for payment to Medicare. Unfortunately, that is exactly where the problem lies for DME owners.

Too few software companies actually focus of cash retention… Yes, “Cash Retention”, this should not be a new concept. It’s actually a dream many DME owners share these day’s as third party auditors find faster ways to identify potential overpayments by filtering millions of claim records looking for losing combinations of billed items that are not technically compatible. An example of this would be the infamous Commode which according to LCD cannot be distributed with an ambulatory assist device such as a, wheelchair, cane or walker.

Any third party auditing agency can run a simple query on your claims history going back as far as 2009 to reveal every instance where you were paid for a commode and a walker or wheelchair for the same date of service. We recently spoke to Thomas Tilahun, Administrator for Oceanside Home Health Services a Los Angeles based DME and Home Health Agency and learned that he’s been dealing with this very issue along with many other DME owners across the country. What we’ve learned is these types of issues can be avoided with the right software. Jim Yeager, Administrator of MetroMed DME also expressed his experience with commodes and know he could benefit from having the right software. bflow® users are seeing the benefit of its “Audit as you go” accountability module that actually requires that the order meet LCD guidelines prior to payment.

This forward thinking application is saving money for many DME companies looking for a business management platform that will protect and alert them to potential issues with their orders. bflow® also has an integrated audit tracking component that quantifies the impact of Audits of your organizations bottom line. When responding to audits bflow® users can produces the required documentation by downloading the correct patient documentation form the electronic medical record and file storage system which comes standard with the application. To learn how you too can benefit from an advanced billing software contact Tom Wright at (888) 612-0466.