DME Medical Billing Services

DME billing is compliance-intensive. One missing ABN, one incorrect HCPCS modifier, or one failed prior authorization—and thousands in revenue vanish.

Neo MD fixes that with DME-certified coders, compliance-focused workflows, and aggressive revenue capture built for equipment and supply complexity.

93–95%

First-Pass Acceptance

28%

Avg Revenue Increase

90

Days to Results

Is Your DME Company Losing
6-Figures Annually? (Most Are.)

If any of these are happening, you’re losing $280K–680K+ per year:

Visible Revenue Bleed

Immediate Impact

Priority: Critical
Audit Code: DME-901

Power Wheelchair Claims Denied

Incomplete documentation or missing face-to-face requirements

Priority: High
Audit Code: DME-902

CPAP Supplies Rejected

Compliance data not submitted with the claim

Priority: High
Audit Code: DME-903

Diabetic Supplies Denied

Frequency exceeded without proper documentation

Priority: Critical
Audit Code: DME-904

Orthotic/Prosthetic Claims Rejected

Missing proof of delivery (POD)

Priority: Medium
Audit Code: DME-905

Hospital Bed Rentals Underpaid

Incorrect billing month methodology

Priority: High
Audit Code: DME-906

Oxygen Equipment Denied

Failed medical necessity documentation

Invisible Losses

According to industry data, DME suppliers lose 26%–38% of revenue due to:

NU, RR, UE, KX, GA, GZ are missing

Modifier Application

24% underpayment

High-dollar equipment delays

Prior Authorization Failures

$18K-$42K/month

Purchase vs rental billing

Capped Rental Errors

Critical errors

Accessories missed

Replacement Supply Underbilling

20% revenue loss

Delivery proof absent

POD Documentation Missing

Auto-denial

Visit documentation gaps

Face-to-Face Compliance

Audit trigger

Incorrect POS codes

Place of Service Errors

Systematic denials

Non-covered item liability

ABN Violations

Compliance risk
"You invested in inventory and relationships. But right now, coding errors cost more than your entire sales team's salaries."
Cumulative Revenue Variance
$680,000+
Per Annum Potential

Why General Medical Billing Companies Fail DME Suppliers

DME billing requires specialized compliance knowledge that general billers don’t have.

HCPCS modifier blindspot

Don't understand KX, GA, GZ, NU, RR, UE requirements

Prior authorization chaos

Miss requirements by payer and product category

Capped rental confusion

Can't navigate purchase vs rental rules correctly

POD documentation gaps

Don't track proof of delivery requirements

Face-to-face failures

Can't obtain and submit the required documentation

Compliance data miss

Don't submit CPAP and oxygen compliance properly

ABN implementation errors

Fail to use advanced beneficiary notices correctly

LCD policy violations

Can't handle complex modifier combinations

Result: 28%–42% denial rates, compliance violations triggering audits, and massive revenue loss on high-dollar equipment.

The Neo MD DME Advantage

DME-Certified Coding Teams

  • Expert in HCPCS coding (E, K, L codes and modifiers)
  • Medicare DME MAC policy knowledge (CGS, Noridian, Palmetto, NGS)
  • Modifier mastery (KX, GA, GZ, NU, RR, UE, BP, BR, BU)
  • Capped rental versus purchase determination
  • Proof of delivery and compliance documentation
  • LCD and NCD policy compliance

→ 93–95% clean claim rate vs 58–72% industry average

Prior Authorization Management

We handle authorizations for:

  • Power wheelchairs and scooters (Group 2, Group 3, Group 4)
  • Hospital beds and pressure-reducing mattresses
  • CPAP and BiPAP equipment
  • Oxygen concentrators and liquid oxygen systems
  • Orthotic and prosthetic devices
  • Lymphedema pumps and diabetic shoes

→ 5.2-day turnaround instead of 12–18 days

Compliance Documentation Management

We ensure proper documentation for:

  • Face-to-face visit requirements (detailed written orders)
  • Proof of delivery with beneficiary signature
  • CPAP compliance data submission
  • Oxygen qualifying test results (ABG, oximetry)
  • Certificate of medical necessity (CMN) completion
  • Advanced beneficiary notices (ABN) when required

→ Zero compliance-related denials

Complex Modifier Application

We optimize billing with:

  • KX modifier for medical necessity compliance
  • GA modifier for ABN on file
  • NU/RR/UE modifiers for purchase/rental/used equipment
  • RT/LT modifiers for bilateral items
  • BP/BR/BU modifiers for purchase/rental options
  • Modifier combinations for specific equipment

→ $15K–$35K monthly recovery from correct modifier usage

Capped Rental Revenue Optimization

We maximize reimbursement for:

  • 13-month capped rental item tracking
  • Continuous rental equipment billing
  • Rent-to-purchase transitions
  • Maintenance and service fee billing after cap
  • Frequent and infrequent replacement schedules

→ $12K–$28K monthly from rental optimization

Real-Time Revenue Visibility

  • Daily high-dollar claim tracking
  • Weekly prior authorization status monitoring
  • Monthly financial performance by product category
  • Quarterly LCD policy compliance reviews

→ Complete transparency

DME Products & Services We Master

Mobility Equipment

 Power wheelchairs, including Group 2, Group 3, and Group 4 complex rehab with proper evaluation and medical necessity documentation, manual wheelchairs with custom seating and positioning components, mobility scooters with documentation of mobility limitations, wheelchair accessories and custom modifications, patient lifts and transfer equipment, and walkers and rolling walkers with appropriate HCPCS code selection.

Respiratory Equipment

CPAP and BiPAP machines with compliance data tracking and submission, oxygen equipment including concentrators, liquid systems, and portable devices with qualifying test documentation, nebulizers and compressors with appropriate frequency billing, ventilators for home use with complex medical necessity requirements, suction machines and airway clearance devices, and respiratory supplies including masks, tubing, filters, and disposable accessories.

Hospital Beds & Support Surfaces

Semi-electric and fully electric hospital beds with medical necessity documentation, low air loss mattresses and alternating pressure systems for pressure ulcer prevention, bariatric beds and accessories for patients exceeding weight limits, bed rails and trapeze bars billed separately when appropriate, overbed tables and bedside equipment, and mattress overlays and positioning cushions.

Diabetic Supplies

 Blood glucose monitors and continuous glucose monitoring systems, diabetic testing supplies including test strips and lancets with frequency tracking, insulin pumps and pump supplies with proper HCPCS coding, diabetic shoes and inserts with certification documentation, diabetic compression stockings, and wound care supplies for diabetic ulcers.

Orthotic & Prosthetic Devices

 Custom-fabricated orthoses, including spinal, lower limb, and upper limb devices with proper L-code selection, off-the-shelf orthotic devices with appropriate modifiers, prosthetic limbs and components with detailed specifications, custom-molded shoes and foot orthoses, compression garments for lymphedema management, and orthotic and prosthetic repairs and adjustments.

Home Medical Equipment

 Patient lifts and slings with weight capacity documentation, commode chairs and shower chairs with medical necessity, enteral feeding pumps and supplies, suction machines for home use, phototherapy equipment for neonatal jaundice, and home infusion pumps and supplies with proper setup and training documentation.

Real Results: Regional DME Supplier (Multi-State)

“We were drowning in power wheelchair denials. Neo MD fixed our prior authorization process, corrected our modifier usage, and implemented compliant documentation workflows. Our denial rate dropped from 35% to under 5%, and revenue is up 34%.”

— Michael R., DME Company Owner

Metric Before NEO MD After NEO MD (90 Days)
Denial Rate on Power Wheelchair Claims 35% 4.8%
Annual Revenue Loss $720,000 Recovered
Power Wheelchair Approval Rate Delayed / Inconsistent +$26,000 / month
Prior Authorization Turnaround 18 Days Average 5.2 Days
Modifier Accuracy Missing on 60% of Claims +$18,000 / month
Compliance Documentation Accuracy Frequently Rejected 98%+
Total Revenue Impact Missed Revenue $72,000 / month
($864K annually)

Free Download

DME Denial Prevention Checklist

The exact checklist our coders use for 93%+ clean claims.

HCPCS modifier decision tree (KX, GA, GZ, NU, RR, UE, BP, BR, BU)

Prior authorization requirements by product category and payer

Face-to-face documentation checklist (detailed written order elements)

Proof of delivery template with required signatures and dates

CPAP compliance data submission requirements

Capped rental billing calendar (13-month tracking worksheet)

ABN implementation guide (when required, proper completion)

LCD policy quick reference for common DME items

Used by 140+ DME suppliers. Worth $3,100. Yours free.

Performance: Neo MD vs Industry Standard

Performance Metric Industry Avg Neo MD
Clean Claim Rate 58–72% 93–95%
Denial Rate 28–42% 4–7%
Prior Auth Approval Rate 68–79% 96%+
Modifier Accuracy 54–68% 97%+
Compliance Documentation 62–76% 98%+
Power Wheelchair Success Rate 52–67% 94%+

Our Process: Revenue Acceleration in 90 Days

Step 1 (Week 1)
Free 90-Day Revenue Diagnostic

 We begin with a comprehensive analysis of your last 90 days of billing data, examining every power wheelchair claim for documentation completeness and prior authorization accuracy, reviewing modifier application across all product categories, evaluating proof of delivery and face-to-face documentation compliance, and assessing capped rental item tracking and billing methodology. Our team identifies denial patterns by product type and payer, reviews LCD policy compliance for high-dollar equipment, and examines advance beneficiary notice implementation. You receive a detailed report showing exactly where revenue is leaking, with specific examples of denied claims and the dollar amount being lost to each type of compliance error or missing documentation.

Step 2 (Weeks 2-3)
Seamless Transition

Our implementation team coordinates a smooth transition with zero disruption to your delivery schedule or customer service. We integrate with your DME software system (whether you're using Brightree, Kareo, HME Business Plus, or any other platform), verify all payer enrollments and accreditation including Medicare DME MAC, set up prior authorization tracking workflows with automated alerts, establish proof of delivery and face-to-face documentation protocols, and provide comprehensive training to your intake staff, billing team, and delivery personnel on HCPCS coding, modifier requirements, and compliance documentation standards. Most suppliers have their first clean claims submitted within 10-12 business days.

Step 3 (Days 30-90)
Revenue Acceleration

This is where you see immediate financial impact. Our certified DME coders begin implementing correct modifier combinations on every claim to maximize reimbursement and prevent denials, establishing systematic prior authorization processes that reduce approval times from weeks to days, ensuring complete compliance documentation, including face-to-face visits, proof of delivery, and medical necessity support, and optimizing capped rental billing with accurate month tracking and timely rent-to-purchase conversions. We systematically rework and resubmit old denied claims with corrected coding, complete documentation, and proper modifier application. Within the first 30 days, most suppliers see noticeable cash flow improvement from power wheelchair and high-dollar equipment approvals, and by day 90, our clients average a 29-34% revenue increase without expanding product lines or adding sales territory.

Step 4 (Ongoing)
Continuous Optimization

 Revenue optimization doesn't stop at 90 days. We provide bi-weekly updates on Medicare DME policy changes and LCD modifications as DME MACs issue new coverage determinations, conduct monthly coding reviews to ensure continued HCPCS accuracy and proper modifier application, perform quarterly compliance audits on face-to-face documentation, proof of delivery, and ABN implementation, and deliver annual training on DME coding updates and payer policy changes. As you add new product lines like CGM systems, lymphedema pumps, or specialized respiratory equipment, we proactively research coverage policies and implement billing protocols to ensure maximum reimbursement and compliance from day one.

Critical Compliance Issues We Handle

DME suppliers face intense regulatory scrutiny. We protect you:

Face-to-face documentation requirements

detailed written order, visit timing, physician signature

Proof of delivery compliance

beneficiary signature, delivery date, equipment specifications

HCPCS modifier accuracy

correct modifier combinations, medical necessity substantiation

Prior authorization tracking

timely submission, complete documentation

Capped rental billing rules

13-month cap tracking, rent-to-purchase transitions

LCD/NCD policy compliance

coverage criteria, frequency limitations

ABN implementation

proper timing, correct form completion, signature requirements

Accreditation standards

maintaining quality standards, audit readiness

We keep you compliant, paid, and audit-ready.

Frequently Asked Questions

 10–14 days, zero delivery disruption.

 Yes. We manage all prior authorizations, including power wheelchairs, oxygen, and complex rehab.

We maintain expertise across all Medicare DME MACs (CGS, Noridian, Palmetto, NGS) and their specific LCDs.

 6–10% of collections, but clients average a 29–34% revenue increase.

Yes. We handle Medicare, Medicaid, commercial insurance, and managed care plans.

We provide audit defense support, including documentation review and appeal representation.

Stop Losing $23K–$57K Every Month

Every month you delay is another month of compounded clinical leakage.

Power wheelchair claims denied

Prior authorizations delayed

Missing modifiers reducing payment

Compliance documentation rejected

Capped rentals billed incorrectly

ABN violations creating liability

Partner with Neo MD

Operational Performance Protocol

Clean Claims Rate
93–95%
Denials below 5%
60 Days
Revenue up 29–34%
90 Days
Prior auth approval
96%+
Modifier accuracy
97%+
Compliance documentation
98%+

Power wheelchair success

94%+

Two Ways to Get Started

Option 1

Free Revenue Analysis

No obligation. No sales pitch. Just data.

We’ll show you:

Option 2

Talk to a Specialist

15-minute consultation. Zero pressure.

We’ll discuss:

Or call us directly:

Monday-Friday, 8 am-5 pm EST

The Cost of Waiting

If you’re a DME supplier collecting $3.2M annually and losing 31% to billing inefficiencies:

$992,000

Per year in lost revenue

$4.96 million

Over 5 years

That’s expanding into new product lines, opening additional locations, investing in inventory and delivery vehicles, or building a comprehensive complex rehab program.

Every month you wait costs you $82,700 you'll never recover.

The question isn’t “Should I switch?”
The question is: “How much more am I willing to lose?”

Neo MD Inc. | DME Medical Billing Specialists

 Trusted by 140+ DME suppliers across all 50 states