HME/DME Outsourcing
Traditional Outsourcing (HME/DME)
In traditional Outsourcing, ACU-Serve assumes all of the provider’s in-house billing staff responsibilities.
The provider will do all intake and compliance reviews for claims to be worked by ACU-Serve.
After the claim has gone through the compliance review and other intake functions, ACU-Serve will provide the following:
-
Review all claims prior to submission for billing errors
(ie: HCPCS codes, Modifiers etc.) - Transmit claims (after review)
- Work front end rejections
- Work A/R and Denials
- Post payments
- Conduct bi-weekly calls to provide feedback
- Conduct monthly executive call and billing analysis
- Implement ACU-Insight Dashboard to provide a transparent view of all activity performed by ACU-Serve
AR Collection Services
ACU-Serve will work all open AR identified by your company, allowing your team to focus on growth opportunities.
ACU-Serve Responsibilities
Front end rejections
Batch failures
Denials
Open AR
Print HCFAs
Price Table, System and Payer Optimization
Batch failures
Denials
Open AR
Print HCFAs
Price Table, System and Payer Optimization
Cash Posting
- Post all payments
- Identify Refund liabilities
- Post all denials
- ERA/ERN optimization
Client Responsibilities
Non ACU-Serve payers front end rejections, collections, and cash posting
Prior Authorizations – New, Expired, and Expiring
CMNs – New, Expired and Expiring
Additional Documentation needed to collect open / submitted AR
Patients New to Medicare
Prior Authorizations – New, Expired, and Expiring
CMNs – New, Expired and Expiring
Additional Documentation needed to collect open / submitted AR
Patients New to Medicare
New Insurance for denied patients if ACU-Serve is unable to identify the new insurance
Equipment Restarts due to initial non-qualifying or insurance changes
New 5 – Year RUL patients
Pre and Post pay audits and all associated denials
Equipment Restarts due to initial non-qualifying or insurance changes
New 5 – Year RUL patients
Pre and Post pay audits and all associated denials