HME Billing and DME Billing: What’s the Difference?

HME billing and DME billing do have differences — here’s how. 

What separates successful HME companies those that falter? Efficiency. Although you need smart solutions at every level of your business, billing is an especially critical area. So, let’s revisit the basics of billing that are key to building a strong company. There are two main types of billing for medical equipment providers: HME billing and DME billing.

So, what’s the difference between HME billing and DME billing? How can you build a strong foundation with your medical equipment billing system? To answer these questions, let’s go back to the beginning.

What is HME Billing?

HME refers to medical equipment that is appropriate for a home environment and can be managed by a patient or non-professional caregiver. HME billing spans the entire revenue cycle and begins with referrals from hospitals, clinics, and physicians.

Billing then involves steps such as intake, order confirmation, cash posting, and A/R management. Since HME billing requires extensive resources across front- and back-office processes, many businesses choose to outsource their billing to a full-service billing provider.

In short, HME billing is a complex process that begins with a new referral and typically ends with payment on existing balances.

Now, let’s examine how DME billing is different.

What is DME Billing?

DME refers to any durable medical equipment that provides therapeutic benefits to a patient with certain medical conditions. Examples of DME include oxygen tanks, walkers, and blood sugar monitors. Thus, DME is a type of HME.

There’s a lot of overlap between DME billing and HME billing because these categories follow similar processes. However, the key difference is the type of device ordered and provided to a patient. So, DME billing still requires the same processes (order confirmation, A/R management, etc.) as HME billing.

Building a Solid Foundation

Billing can make or break your business. Whether you’re looking to tweak your existing approach or implement new solutions, you need to evaluate your current HME or DME billing processes. Are they causing inefficiency, backlogs, or lost revenue? If so, you can strengthen your billing with the following concrete steps:

Assess Your Current System

For future growth, you should assess your KPIs, payer and product mix, current services, and geographical spread. Efficient processes, up-to-date billing software, and reliable IT infrastructure allow for a billing system that works in your favor. By analyzing these metrics, you can see the gaps in your current system.

Identify Your Goals

What do you want to get from your billing? What kind of solutions fit your business? Most importantly, what does success look like for your company? To answer these questions, you need to identify your areas of focus, set goals, and establish rules of engagement. Quantifying these goals will set you up for success.

Standardize Your Processes

Allow for more growth and scalability by standardizing your company’s processes. Specifically, your senior staff should test the standard operating procedures. Then, stakeholders should sign off prior to their implementation. This way, you keep everyone in the loop and ensure that each team within your company is held to the same standard.

Train Your Team

With standard procedures in place, you are ready to build a high-quality team. Incentivize employees to learn quickly. You should also provide space for them to make and learn from mistakes. Proper training helps reduce human errors in your billing and lessens the impact of reduced resources.

Are you struggling to manage your HME or DME billing? You’re not alone. Contact us to learn about your outsourcing options with Prochant today.

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Prochant is the leading reimbursement firm with a dedicated focus on HME and pharmacy. We have a proven track record of helping HME and pharmacy providers meet their financial goals. Our scalable solutions, years of experience, and advanced technology provide best-in-class results to the healthcare community. Headquartered in Charlotte, North Carolina, our client base includes national HME and pharmacy providers and health systems.