DME Billing Services
In traditional Outsourcing, QHS 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 QHS.
After the claim has gone through the compliance review and other intake functions, QHS 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
- Implement QHS-Insight Dashboard to provide a transparent view of all activity performed by QHS
AR Collection Services
QHS will work all open AR identified by your company, allowing your team to focus on growth opportunities.
QHS Responsibilities
- Front end rejections
- Batch failures
- Denials
- Open AR
- Price Table, System and Payer Optimization
- Cash Posting
- Post all payments
- Identify Refund liabilities
- Post all denials
- ERA/ERN optimization
Client Responsibilities
- Non QHS 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
- New Insurance for denied patients if QHS is unable to identify the new insurance
- Equipment Restarts due to initial non-qualifying or insurance changes
- Pre and Post pay audits and all associated denials
- New 5 – Year RUL patients