See where your DME claims are leaking revenue
The DME Denial Scorecard is a short self-assessment across the areas where DME revenue is usually won or lost. Use it to spot the gaps most likely costing you denials, then talk to our team about closing them.
The areas that drive DME denials
Each area below is where DME claims most often slip. The full scorecard scores you on each.
Documentation (SWO + POD)
Are your Standard Written Orders and proof of delivery complete before claims go out?
Orders and proof of delivery are verified complete and matched to the billed item and date before submission, not after a denial.
Coding and modifiers
Are HCPCS codes and DME modifiers accurate and current for each item?
HCPCS codes and DME modifiers are accurate and reviewed against current payer rules for every item and scenario.
Eligibility and authorization
Do you verify coverage and secure prior authorization up front?
Coverage is verified and any required prior authorization is secured up front, before delivery, so nothing is denied after the work is done.
Denials and appeals
Are denials worked at the root cause, or just resubmitted?
Denials are triaged by recoverable value, worked at the root cause, and fed back into the front end so the same ones stop recurring.
A/R and timely filing
Is aging worked by value and timely-filing risk?
Aging is worked by recoverable value and timely-filing risk, so the dollars most at risk are handled before deadlines pass.
Capped rental and sequencing
Are capped-rental months and modifiers tracked accurately?
Capped-rental months and modifiers are tracked accurately so each month bills correctly through the full rental sequence.
Get your scorecard
The full interactive scorecard, with your personalized score and a downloadable Top 10 DME Denial Reasons and Fixes guide, is on the way. In the meantime, talk to our team for a walkthrough of these areas, or read the denial guide now.
Ready to close the gaps?
Get a consultation and we'll walk your DME workflow and show you exactly where denials start.