I’m trying to start a business in medical supplies and I need to know how to bill insurance companies.
I assume you’re talking about DME (Durable Medical Equipment) billing and that you’re well versed in the nuances of DME. I personally haven’t billed medical equipment but understand it can be a very lucrative specialty.
When it comes right down to it, DME medical billing isn’t much different than billing for physicians. You still have to submit claims, keep up with co-pay’s, co-insurance, write-offs, patient responsibilities, etc. – as well as be familiar with the CPT medical billing codes unique to medical supplies. I go into more detail on the billing process here.
To start billing insurance companies requires submitting claims on behalf of patients – either electronically or paper. This requires some sort of practice management or billing software.
As you probably know there’s a lot of DME medical billing software programs available – or standard medical billing/practice management programs that can be used for DME billing.
It’s almost overwhelming the choices available. I would recommend using one of the more popular programs like Lytec, AltaPoint, Medisoft – the list goes on… You can expect to spend around $1000 and up for a single user license.
To submit claims electronically requires a Clearinghouse – unless you want to submit to each individual carrier separately – but I wouldn’t recommend. The cost starts at about $80/month. I use ENSHealth (www.enshealth.com) and have been very pleased with them.
Or you may want to checkout Kareo. They’re an online medical billing service that starts at about $70/month with no long term contracts. It also includes electronic claim submission and can be accessed from any PC with a browser. I haven’t started using it yet but plan to with our next client. I’ve read good reviews on it.
here’s also a company called AdvanceMD – but I’m not as familiar with them or their pricing and services. I think online is the future for medical billing software – no upfront costs, upgrades, maintenance, servers, backup, etc.
If you’re just getting started and don’t have a lot of claims yet, the most economical route would be to file paper claims – it’s a lot cheaper. The only drawback is it takes a little longer to get payments.
Speedysoft Speedy Claims file and print software available for about $115. The only problem is you still have to keep up with claim status and all the other accounting function (like co-insurance, co-pays, patient balances, etc.). But SpeedySoft also offers a Speedy Ledger for $75 that’s compatible and complements Speedy Claims file and print. Check out SpeedSoft here.
Thanks for the question Mike – I hope I’ve not rambled too much and given you some helpful info. Feel free to look around the site and see if there’s anything else that might be helpful.