DME Rebuttals to Insurance Companies

Claim denials for DME or durable medical equipment are one of the most common issues facing medical facilities today. DME refers to durable goods, medical supplies or home care products that can withstand repeated use, and ranges from ventilators, oxygen tanks, adjustable hospital beds, and wheel chairs to ankle supports, body braces, canes, cannulas, car seats, cervical collars, and more.

The filing of improper claims for DME use and supply has made insurance companies extra cautious when it comes to payment for such claims. Managed Outsource Solutions (MOS) offers legal professionals the necessary support in the submission of DME rebuttal letters and appeals to insurance companies.

DME rebuttals to insurance companies become necessary when DME suppliers and health care providers are refused payment for legitimate insurance claims involving the prescription and use of such equipment. With our wide experience in the medical case review industry, we are well-positioned to handle the entire paperwork in the rebuttal and appeal process. We can help minimize claim denials and maximize reimbursement for DME use.

MOS puts together relevant medical records, documents, chronological case summaries and patient medical history notes that you may need to submit to the insurance company during the DME rebuttal process. This would not be new evidence, but only proof to ensure that the already filed papers are in order or to nullify the objections raised by the company. We can also help you prove to the insurer that:

• the equipment was not included in a claim that was previously settled
• the DME prescription was appropriate for the patient
• all the information in the claim is accurate and valid
• verify the procedure codes used

We can help you draft the rebuttal letter to indicate why the refusal to pay is unjust and should not take place.

Advantages of Associating with MOS

• Our expert team is well aware about critical issues like contractual obligations, representations, insurance company rules
• We can provide rebuttals which include studies, literature, expert opinions and information that will indicate the need for specific DME
• We can help you analyze the reasons for claim denial and submit the DME rebuttal in accordance with insurance guidelines
• We can track your appeals until the insurance company processes the claims completely
• We can help you chalk out an effective DME claim denial management program for your clients to improve their cash flow

We will be glad to provide you with a FREE TRIAL for DME rebuttal services. Call 1-800-670-2809, or use our Contact Us form.