01
Same-or-similar equipment logic and Medicare's reasonable-useful-lifetime rules trigger denials when history is not checked first.
02
Proof of delivery and signed documentation must exist before billing — retroactive paperwork rarely survives an audit.
03
Prior authorization is mandatory for a growing list of HCPCS codes, with resubmission consequences for missing it.
04
Rental vs. purchase logic (capped rental, oxygen, wheelchairs) changes billing cadence and easily creates duplicate or premature claims.
Same-or-similar and history checks before a claim is built, not after a denial arrives.
Documentation checklists — delivery ticket, medical necessity, order detail — tracked per item.
Prior authorization status tracked against the current HCPCS requirement list as CMS updates it.
Rental billing cadence managed so capped-rental and oxygen claims file on the correct monthly cycle.
Engagement path
From specialty audit to steady paid claims
01
Specialty audit
Review recent claims, denials, and CPT patterns for your panel.
02
Edit set tuned
Scrubbing and denial playbooks aligned to your specialty reality.
03
Daily ownership
Submission, follow-up, and appeals with a named next step every time.
04
Clear reporting
Production, collections, and aging in plain language — monthly.
01
Do you check same-or-similar history before billing?
Yes — checking prior equipment history is a standard step before we submit, since it is one of the most common DME denial reasons.
02
Can you manage prior authorization for us?
We track and submit PA requests for codes that require it and flag status before the item ships whenever the workflow allows it.
03
How do you bill capped rental equipment?
On the monthly cycle Medicare and commercial payers require, with ownership conversion handled at the correct month rather than billed early or late.
