Latest news with #DurableMedicalEquipment
Miami Herald
6 days ago
- Business
- Miami Herald
GenHealth.ai Launches AI-Powered Order Automation Solution for Home and Durable Medical Equipment (HME / DME) Providers
Revolutionizing DME Operations: Seamless Automation from Intake to Billing BOSTON, MASSACHUSETTS / ACCESS Newswire / June 4, 2025 / today announced the launch of its AI-powered automation solution specially designed for Durable Medical Equipment (DME) and Home Medical Equipment (HME) providers, helping relieve the burden of complex workflows such as medical order intake, eligibility verification, and prior authorizations. This launch marks a major expansion of mission to bring intelligent, scalable automation to healthcare operations-boosting accuracy, reducing delays, and accelerating access to care. Developed in close partnership with early DME customers, platform streamlines the medical order lifecycle using new advancements in AI and Large Language Models (LMMs)-combined with deep integrations into existing EMR and billing systems-specifically for DME and HME providers. Key capabilities include: Automated Patient Intake: Consolidates all incoming orders-fax, email, EHR, and portals-into a single inbox. Processes even handwritten forms and fills in data to billing systems and electronic medical Coverage & Eligibility Checks: Verifies insurance coverage through clearinghouses or direct payer integrations, extracting key plan-level details like deductible status, coverage limits, and Necessity & Prior Auth Submission: Compares clinical documentation-such as physician notes-against payer policy requirements, identifying gaps in real time, ensuring every order is audit-ready before it hits the billing Billing Integration: Pushes claim-ready orders directly into systems like Brightree and NikoHealth, eliminating rekeying and toggling between Insight into Payment Analytics: Compare reimbursement rates against historical benchmarks and peer performance metrics using GenHealth's Large Medical Model (LMM). Early Results: Less Manual Work. Higher Accuracy Across early implementations, has delivered: 4x increase in orders processed per employee50% reduction in manual review time95%+ alignment with human utilization management (UM) decisions "With AI, customers are able to bring on our AI agent to help their existing teams process more cases and increase revenue while reducing administrative costs." said Ethan Siegel, CPO. Ricky Sahu, CEO, added "DME providers deserve tools that reduce friction across every step of the order process-and they shouldn't have to rip out their systems to make it work. Our AI integrates into existing customer apps without disrupting how their teams work today." Expanding the Vision for Smarter Healthcare Operations In addition to the DME solution, has developed a prior authorization automation solution for providers, designed to accelerate access to high-cost therapies such as GLP-1s and chemotherapies. By combining AI, patient charts, and payer-specific coverage logic, the platform helps providers achieve faster patient-centered approvals-resulting in higher approval rates. will be showcasing these capabilities live at the VGM Heartland Conference in Waterloo, IA, on June 10-11, 2025 and at ENDO 2025 in San Francisco, CA, on July 12-14, 2025. About is a healthcare automation company building AI-powered infrastructure for modern care delivery. The company's platform uses a proprietary Large Medical Model (LMM) to understand real-world clinical data, payer requirements, and operational workflows. helps providers, DME suppliers, and care teams reduce administrative burden, improve accuracy, and accelerate patient access to care-all through intelligent, end-to-end automation. To learn more, contact hello@ or visit Contact Information Mike Maseda Head of Operationsmarketing@ SOURCE: Genhealth AI press release
Associated Press
6 days ago
- Business
- Associated Press
GenHealth.ai Launches AI-Powered Order Automation Solution for Home and Durable Medical Equipment (HME / DME) Providers
Revolutionizing DME Operations: Seamless Automation from Intake to Billing BOSTON, MASSACHUSETTS / ACCESS Newswire / June 4, 2025 / today announced the launch of its AI-powered automation solution specially designed for Durable Medical Equipment (DME) and Home Medical Equipment (HME) providers, helping relieve the burden of complex workflows such as medical order intake, eligibility verification, and prior authorizations. This launch marks a major expansion of 's mission to bring intelligent, scalable automation to healthcare operations-boosting accuracy, reducing delays, and accelerating access to care. Developed in close partnership with early DME customers, 's platform streamlines the medical order lifecycle using new advancements in AI and Large Language Models (LMMs)-combined with deep integrations into existing EMR and billing systems-specifically for DME and HME providers. Key capabilities include: Early Results: Less Manual Work. Higher Accuracy Across early implementations, has delivered: 'With AI, customers are able to bring on our AI agent to help their existing teams process more cases and increase revenue while reducing administrative costs.' said Ethan Siegel, CPO. Ricky Sahu, CEO, added 'DME providers deserve tools that reduce friction across every step of the order process-and they shouldn't have to rip out their systems to make it work. Our AI integrates into existing customer apps without disrupting how their teams work today.' Expanding the Vision for Smarter Healthcare Operations In addition to the DME solution, has developed a prior authorization automation solution for providers, designed to accelerate access to high-cost therapies such as GLP-1s and chemotherapies. By combining AI, patient charts, and payer-specific coverage logic, the platform helps providers achieve faster patient-centered approvals-resulting in higher approval rates. will be showcasing these capabilities live at the VGM Heartland Conference in Waterloo, IA, on June 10-11, 2025 and at ENDO 2025 in San Francisco, CA, on July 12-14, 2025. About is a healthcare automation company building AI-powered infrastructure for modern care delivery. The company's platform uses a proprietary Large Medical Model (LMM) to understand real-world clinical data, payer requirements, and operational workflows. helps providers, DME suppliers, and care teams reduce administrative burden, improve accuracy, and accelerate patient access to care-all through intelligent, end-to-end automation. To learn more, contact [email protected] or visit Contact Information Mike Maseda Head of Operations [email protected] SOURCE: Genhealth AI press release
Time Business News
18-05-2025
- Business
- Time Business News
Avoiding Common Compliance Pitfalls in DME RCM
Durable Medical Equipment (DME) providers face a complex landscape when it comes to managing revenue cycle operations. With stringent regulatory requirements, evolving payer policies, and increasing scrutiny from auditors, maintaining compliance is both critical and challenging. Avoiding common compliance pitfalls in DME RCM (Revenue Cycle Management) is essential for safeguarding revenue, reducing claim denials, and ensuring long-term operational success. In this article, we'll explore the most frequent compliance challenges DME providers encounter, practical strategies to mitigate risks, and how to optimize your revenue cycle while staying aligned with regulatory demands. Before diving into pitfalls, it's important to understand why compliance matters so much in the DME space. DME suppliers must adhere to regulations from Medicare, Medicaid, and private insurers, which govern: Documentation requirements Medical necessity Billing accuracy Supplier standards Non-compliance can result in claim denials, financial penalties, audits, and even exclusion from federal programs. One of the most common compliance issues is the failure to maintain proper documentation that supports medical necessity and claim submission. Documentation must include: Physician's order with detailed product descriptions Proof of delivery Patient eligibility verification Patient's medical records demonstrating need How to Avoid: Implement standardized documentation protocols and regularly audit records. Using electronic health records (EHR) systems integrated with your billing software can help ensure consistency and completeness. Coding errors can lead to improper billing, triggering claim denials or overpayment allegations. Common mistakes include: Using outdated or incorrect HCPCS codes Billing for non-covered items or services Duplicate billing How to Avoid: Train billing staff continuously on the latest coding updates and conduct routine billing reviews. Leveraging coding software with built-in compliance checks can reduce human error. Submitting claims without verifying patient insurance coverage or eligibility often results in denials and delays in payment. Eligibility issues are especially prevalent with secondary insurance and Medicaid. How to Avoid: Integrate real-time eligibility verification tools in your billing process to check patient coverage before claims submission. Medicare enforces strict supplier standards under the Competitive Bidding Program (CBP) and accreditation rules. Failure to meet these can lead to penalties or exclusion. How to Avoid: Stay updated with Medicare's supplier standards and ensure your accreditation and licensing are current. Regular internal audits and staff training on Medicare requirements are vital. Many DME providers underestimate the importance of being audit-ready. Audits by Medicare and other payers can be disruptive and costly if documentation or compliance is lacking. How to Avoid: Develop an audit response plan, maintain organized records, and perform mock audits periodically. Engaging external consultants specializing in DME compliance can provide an objective review. Efficient DME revenue cycle management depends on leveraging technology to reduce compliance risks and enhance operational efficiency. Automated billing systems, electronic document management, and real-time reporting tools provide visibility into compliance status and financial performance. Providers who integrate technology solutions benefit from: Reduced manual errors Faster claim processing Enhanced compliance monitoring Adopting a comprehensive revenue cycle management platform tailored for DME can help streamline workflows and ensure adherence to regulatory requirements. Compliance is not a one-time effort. Regular training programs for clinical and administrative staff keep everyone informed about regulatory changes and best practices. Topics should cover: Coding updates Documentation standards Audit readiness Fraud, waste, and abuse prevention Investing in ongoing education helps create a culture of compliance and reduces the risk of costly errors. Avoiding common compliance pitfalls in DME RCM requires a proactive approach combining accurate documentation, proper coding, eligibility verification, adherence to supplier standards, and audit preparedness. Leveraging technology and investing in continuous education are critical to managing these challenges effectively. By focusing on these strategies, DME providers can minimize compliance risk TIME BUSINESS NEWS
Yahoo
07-03-2025
- Health
- Yahoo
Finding Dexcom monitors amid shortages
(COLORADO SPRINGS)– FOX21 News has learned alternative ways people are getting around the shortage of the medical device called the Dexcom, a glucose monitor for diabetes. Some diabetics are now turning away from pharmacies to get the device. 'Anybody can find a wheelchair somewhere, right? But where are you going to always find this kind of technology that's going to help you this much?' said Rodney Scurry, the regional manager of Specialty Medical Equipment. Scurry said his job is to help bypass red tape for both doctors and patients across Colorado. 'I bridge that gap for them. We are a durable medical equipment supplier, which falls under CGM (continuous glucose monitoring),' he said. FOX21's Carolynn Felling, a Type One Diabetic herself, said since she last covered the shortage, she has been able to get her Dexcom through Walgreens, but said she is now thinking about switching to Durable Medical Equipment, or DME. It's a way for people to gain access to devices like the Dexcom that is intended to skip that rep tape often seen with pharmacies. PREVIOUS COVERAGE: Dexcom diabetes monitoring device facing national shortage Scurry said his goal is to help with the supply shortage thousands of people are struggling with. 'My job is to educate our physicians in why using a DME versus a pharmacy is so beneficial, not just for them and make their life easier, but more importantly for the patient and making their life easier and making sure that they get what they need,' Scurry said. When a device is ordered by a physician for everyday or extended use, like the Dexcom, there are other options like using a DME that many people are now turning to in order to skip the long process of waiting through pharmacies, which can result in a lot of pain for patients with unmonitored blood glucose levels or BGL. When diabetics have to go through lengthy waiting periods without a CGM, they are forced to go back to the old-school method of pricking their fingers, which can lead to permanent nerve damage from all the scar tissue. 'I have a friend of mine that, she got pregnant and she was doing 30 finger pricks a day, which means she had to wake up every hour throughout the night to prick her fingers,' he said. '[The Dexcom] is life changing for her, she can sleep. This is so meaningful and it's so impactful to people's lives.' Scurry said those long periods of waiting for the medical device is due to a limit on how much supplies pharmacies can get. 'When I went to the pharmacy, the pharmacy informed us that they only get 24 FreeStyle Libre's (another brand of glucose monitor) and they only get 18 Dexcom until their next shipment comes in,' he said. If anyone is struggling with the shortage of Dexcom devices, Scurry said he has more than enough currently available. To contact him, call at (719) 306-6169. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
