DME billing and claims management can be a daunting task. Dealing with innumerable governmental and private insurances, creating and juggling the required paperwork, coordinating customer service, shipping and billing functions, managing insurance denials while maintaining proper inventory levels add to the complexities involved. Efficiently controlling these functions translates into optimal customer service as well as higher sales and profits.
Our Noble*Direct billing and claims management system streamlines the overall billing process and makes it manageable. A central, server-based solution permits simple transmission of claims and supporting documentation to Medicare, Medicaid and over 2300 private carriers. Reimbursements can be applied automatically both for Medicare and many private insurers thus eliminating a time-consuming and tedious posting process. One-time and recurring claims will be seamlessly created and accurately submitted.
In collaboration with major shipping carriers, i.e. Fedex, UPS, USPS, the shipping process may be optimized by streamlining communications between billing and such carriers. Automated "drop-ship" capabilities allow electronic communication between Noble*Direct billing and distributers so that orders can be automatically received, filled and receipts generated.
Accurate financial reporting and in-depth analysis allow the business snapshot required to make necessary changes in direction.
A formal intake process can be employed using our PreQ prospect management system. Prospect demographic data, supplies and equipment required, referral source tracking and custom document preparation are only a few of the important features of PreQ. By utilizing PreQ prospect management, our clients are assured that all required demographic data is collected and that verification takes place as efficiently as possible. Online patient eligibility can be invoked from PreQ prospect management. An interface between the PreQ prospect database and the Noble*Direct patient billing system allows prospect data to be exported and made ready for billing once necessary data is collected and verified.
Maintaining appropriate inventory levels can provide optimal customer service at minimal cost. Either serialized or non-serialized inventory items may be managed using a seamless interface with our billing process. Purchase orders may be produced, lot numbers and expiration dates may be recorded, if necessary, and reports generated for managing inventory levels as well as inventory valuations.
Patient appointments may be generated and maintained for those establishing home or office visits for their clients. Appointments may be established for shoe fittings, respiratory supply services, O & P, etc. using our integrated patient scheduler which is simple to use and has an "Outlook" look and feel. Appointments may be set and managed for multiple office locations or customer service representatives. Such integrated operational features can assist with day to day procedures requiring reduced time and effort.
Noble House’s document imaging and retrieval system makes the storing of critical documents in patient folders a thing of the past. All documents may be scanned and indexed using user-defined image categories. Completed Assignment of Benefit statements, Doctor’s order forms and CMNs, signed delivery tickets as well as documentation from insurance companies may be scanned and immediately available to all users. Barcodes may also be included on each document allowing for a "batch scanning" function as completed documents are returned. Groups of documents may be placed in a scanner’s Automatic Document Feed, then Noble*Direct’s batch scanning feature may be invoked. Image files are thus created for each scanned document; the files are automatically indexed from information contained within the barcode appearing on each document and important document images are available to eligible users.
All historical claims, reimbursements, denials and inventory records are stored within a provider’s database. Accessible historical data makes operational reporting and historical analysis possible with a few keystrokes. A wide array of operational reports are included for sales analysis, denial management, end of month reporting, collections of A/R, inventory analysis as well as pre-defined and custom operational documents. Since all data is ODBC-compliant, various third party report generators are available so that custom reports can easily be generated and be run on demand.
Many DME providers have spent countless hours and therefore, expense producing the historical analysis required by Medicare for the Round 1 Rebid. Since detailed sales data is stored and is available within each provider’s database, such analytical reporting is now available to providers as required. Historical analysis by patient, HCPCS code, MSA region and category of equipment may be generated and recorded according to Medicare’s requirement.
For providers not receiving Medicare contracts in particular MSAs, Noble*Direct may be configured to warn or restrict entry for new patients or transactions within specified MSAs and equipment categories. This function is tightly integrated into Noble*Direct’s patient intake and claims entry process so that such restricted claims do not fall through the cracks.
Noble*Direct integrates both Medicare and private insurance eligibility for new patients and recurring orders. Real-time responses assure that patients are properly insured and that outstanding deductible balances may be collected. Insurance inquiries may be made for any particular patient as well as for groups of patients. "Show me the insurances for all patients whose supplies are being delivered this week" or "Include those patients whose deductible balance is over $100.00" are common batch requests. Locks may also be established which will prevent claims from being transmitted for those patients exceeding particular deductible thresholds.
