DME Prior Authorization

How Staying Ahead in DME Prior Authorization is Your Road to Better ROI

According to an update on February 7th, 2020, the CMS has selected six new items of DMEPOS subject to prior authorization additionally. The following six of the HPCS codes used for Lower Limb prosthetics is going to be added which are: L5856, L5857, L5858, L5973, L5980, and L5987.

The process for this DME prior authorization will be implemented in two phases. The first phase will be beginning from May 11 2020 in one state from each DME MAC jurisdictions. Michigan, California, Texas, Pennsylvania will be ones that will see these implementations one by one!

The second phase will begin on Oct 8th, 2020, and will be expanding prior authorization of these codes to all the remaining territories. As a DME provider, staying ahead in your practice management standards will be the way forward!

Especially with the current crunch standards with finding the right staff will be one of the biggest pain areas. The federal government has already proposed for incentives of $450  a week for returning back. A lot of DME providers will now be looking to outstretch possibilities by finding a reliable DME prior authorization team that can work mobile, offer dedicated support.

Delivering excellence in DME prior authorization

It can be difficult to find resources who know well about the changing situations around, offer great standards of productivity, reducing operational costs, and helping in improving RCM mandates of your organization.

A reliable team that realizes how to deliver an immediate plan for helping you with front office requirements will be a key need. Someone who delivers you the right support and performs all the related activities with sales order creation, DME prior authorization, doctor’s office follow up, performs all that is needed to reduce your daily expenses.

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A team which is experienced

Understanding the precise requirements with daily practice management standards claims adjudication priorities is going to be a critical job for a (durable medical equipment) DME provider. To manage the DSO’s to rising, there has to be a perfect plan in place by making your DME prior authorization, order entry and other activities to be performed watertight.

To conclude, a lot depends on finding a team that can offer the right versatility. It will be a definitive need, especially in an apprehensive market with healthcare participants starting to look at newer ways to grow and expand.

A lot depends on how you are wise enough to find a team that can actually transform your cash resources. While there are a lot of service providers, finding a team specialized in offering DME prior authorization support with confidence is going to be a key feature.

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