Tag: Billing
Compliance: Put billing, accreditation into same silo
September 9, 2026Cheryl Henninger
Q. How can DME providers better align billing documentation with accreditation readiness?
A. The first step is to stop treating billing compliance and accreditation compliance as two separate jobs. In a strong DME operation, they should be looking at the same patient story from two different angles.
Billing asks: Do we have what we need to support medical necessity, coverage, coding, modifiers, continued need and delivery? Accreditation asks: Did we follow our policies, educate the patient,...
Payer relations: Show up prepared
August 11, 2026Cadie McGonagill
Q. How do I work with payers to resolve billing issues?
A. Getting billing issues resolved with payers isn't about who complains loudest – it's about who shows up prepared. A little homework upfront turns a frustrating back-and-forth into a productive conversation.
Know your contract
Before reaching out, review your payer agreement for denial and appeal rights, filing deadlines and required documentation. Timelines vary by plan type and can be short, so missing a window can...
BFLOW Solutions offers personalized portals to pharmacies
August 3, 2026HME News Staff
FRESNO, Calif. – BFLOW Solutions has launched a pre-provisioned trial portal program to expand its participation in CPESN Medical Billing Supports. As a Data Share Compliant Technology Solution Provider, BFLOW says it will deliver ready-to-use, individually configured billing portals to CPESN participating pharmacies – shortening the learning curve, extending data-sharing capabilities, and giving pharmacists a turnkey path to bill practitioner-provider services where the pharmacy is the...
VGM names new billing and reimbursement director
June 8, 2026HME News Staff
WATERLOO, Iowa – VGM & Associates has appointed Stephanie Robinson, who has held leadership roles at Dynamic Healthcare Services, as director of billing and reimbursement. She will work closely with VGM members to improve reimbursement processes, address operational challenges and improve performance. “Billing and reimbursement are among the biggest operational pressures providers are managing today, and Stephanie brings the real-world experience to help our members work through those...
Outsourcing goes from cost cut to core strategy
November 19, 2025Tracy Orzel
Key highlights:
Outsourcing becomes strategic: Providers increasingly view outsourcing as essential for sustainability amid staffing shortages, payer audits and rising operational complexity.
Labor and expertise challenges: High turnover, costly onboarding and specialized billing requirements push providers toward partners with deep industry knowledge and process expertise.
Tech-plus-people approach: Successful outsourcing blends...
OIG report urges monitoring of remote patient monitoring
September 2, 2025HME News Staff
WASHINGTON – The use of remote patient monitoring continued to grow in 2024, with Medicare payments exceeding $500 million, according to a new report from the HHS Office of Inspector General.
Other key takeaways from the report:
Monitoring billing can help safeguard the Medicare program and prevent fraud, waste and abuse.
Billing that may warrant further scrutiny includes billing for a high proportion of enrollees who have no prior history with the medical practice...
Allegiance Group integrates with R2Health
August 25, 2025HME News Staff
OVERLAND PARK, Kan. – Allegiance Group has announced that its COLLECTPlus platform is now integrated with R2Health’s software to streamline billing and improve cash recovery for infusion providers. “We are excited to partner with R2 Health to bring our proven patient billing and collection strategies to their network of specialty infusion providers,” said Bruce Gehring, SVP of business development at Allegiance Group. “Through our COLLECTPlus integration, providers can...
In brief: ACU-Serve merges, Hoveround & Merits partner, ATLAS Technology rebrands
August 6, 2025HME News Staff
AKRON, Ohio – ACU-Serve has merged with Pinnacle Revenue Management, a provider of home infusion and ambulatory infusion center billing services.
"This merger marks a pivotal moment for both ACU-Serve and the infusion industry,” said Jim Knight, president and CEO of ACU-Serve. “By uniting our expertise, talent and technology, we are not only setting a new benchmark for excellence and innovation but also reaffirming our commitment to high-touch service and operational...
Nymbl Systems receives investment
December 23, 2024HME News Staff
COLUMBUS, Ohio – Nymbl Systems, a provider of cloud-based practice management software for orthotics and prosthetics, complex rehab technology and home medical equipment providers, has received an equity investment from Frontier Growth.
The amount of the deal was not disclosed, but Charlotte-based Frontier Growth typically makes initial equity investments of $5 million to $30 million in mission critical vertical SaaS companies with $3 million to $20 million of annual recurring revenue...
Billing: Manage your risk
December 10, 2024Kit Shellhouse
Q. How can I stay compliant with Medicare’s fee-for-service plans?
A. Dealing with Medicare fee-for-service plans can be tricky, but there are ways to manage the risks and stay compliant. Documentation errors are a primary risk, as Medicare is extremely strict, and any mistakes can lead to claim denials or audits. To avoid these risks, ensure all patient records, prescriptions and proof of delivery are thoroughly documented and easily accessible. Billing inaccuracies, such as incorrect...