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Clinical Claim Review Services
Durable Medical Equipment (DME)
EquiClaim, an Emdeon company, has created a unique post-payment review and recovery service specific to analyzing the high volume of low-dollar DME claims billed daily to healthcare providers. Traditionally, billing regulations for these low-dollar claims has been limited because of case volume and the lack of documentation. EquiClaim, an Emdeon company leverages DME industry expertise to analyze and identify cases where inappropriate or unnecessary DME billings occur or where unbundling of services, billing excessive units or incorrect coding occurs. EquiClaim, an Emdeon company, can aggregate historical claims by patient and provider to regulate rental-to-purchase price limits within contract reimbursement provisions.
Policy Compliance Review areas of focus include: