· Reviewed by Nimra Khalid
What is DME billing outsourcing?
DME billing outsourcing means a remote team runs the billing cycle for durable and home medical equipment suppliers: verifying coverage, requesting prior authorization, gathering the physician order, certificate of medical necessity and delivery proof, billing sales and recurring rentals, posting payments and working denials and audits. The supplier keeps its own billing software; the provider works inside it.
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DME billing: what we do and how it runs
DME billing outsourcing means a remote team runs the billing cycle for durable and home medical equipment suppliers: verifying coverage, requesting prior authorization, gathering the physician order, certificate of medical necessity and delivery proof, billing sales and recurring rentals, posting payments and working denials and audits. The supplier keeps its own billing software; the provider works inside it.
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What it is
DME billing outsourcing means a remote team runs the billing cycle for durable and home medical equipment suppliers: verifying coverage, requesting prior authorization, gathering the physician order, certificate of medical necessity and delivery proof, billing sales and recurring rentals, posting payments and working denials and audits. The supplier keeps its own billing software; the provider works inside it.
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What you get
Authorizations and documentation complete before the item ships
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How it runs
Rental months and resupply windows billed on the cycle date, never missed
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Billing audit call
A 30-minute call to map your product lines, payers, billing software, monthly order volume and active rental count. We review recent denials, pending authorizations and any open audit requests.
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A named accountant, a backup and a team lead
Inside your own software, on a fixed close calendar, with a reply from a person within 1 business day. Call +1-657-777-0006 or start a quote.
Book a billing audit 06 / 06
Who it is for
Independent DME and HME suppliers
You supply mobility, respiratory, sleep or wound care products and one biller is juggling authorizations, rental calendars and audits. Missed rental months are costing you money you never see.
Pharmacy and medical supply owners
DME is a growing line alongside your main business and the documentation rules are different from everything else you bill. You want it handled by people who do it daily.
Multi-location suppliers
Several branches, several payers and one rental fleet need one authorization log, one billing calendar and one reconciled set of books.
What's included
- Eligibility, same-or-similar and coverage checks before intake is accepted
- Prior authorization requests submitted and chased until a decision
- Physician order, CMN and clinical note collection from the ordering provider
- Proof of delivery and patient signature filed with every claim
- Sales claims to Medicare DME MACs, Medicaid and commercial payers
- Capped rental and oxygen rental months billed on the cycle date
- Resupply eligibility windows tracked and billed when the patient qualifies
- ERA and EOB posting with adjustments coded by reason
- Denial rework, redeterminations and appeals with supporting documents
- Patient co-pay and deductible statements under your company name
- Documentation packets for payer audit and additional documentation requests
- Monthly reconciliation of posted payments to bank deposits and the ledger
Deliverables and KPIs
| Deliverable | KPI we report | Cadence |
|---|---|---|
| Authorization requests | Submitted within 1 business day of a complete order | Daily |
| Authorization outcomes | Approvals, denials and pending requests reported with reasons | Weekly |
| Rental billing | Every active rental billed on its cycle date; zero missed rental months | Monthly |
| Remittances posted | ERAs posted within 1 business day of receipt | Daily |
| Denials worked | Every denial touched within 5 business days with a next action | Weekly |
| Revenue reconciliation | Posted payments tied to deposits and the ledger with variances explained | Monthly |
KPIs are what we measure and report, agreed per engagement. Service-level commitments are set in your agreement.
How it works
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Billing audit call
A 30-minute call to map your product lines, payers, billing software, monthly order volume and active rental count. We review recent denials, pending authorizations and any open audit requests.
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BAA, access and payer setup
We sign a business associate agreement and you grant role-based access to Brightree or your billing system, payer portals and your document storage. Fee schedules, rental rules and documentation checklists are confirmed in week one.
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Dedicated biller assigned
A named biller, a trained backup and a team lead take over intake review, authorizations and claim runs. The first rental cycle runs in parallel with your current process.
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Daily queues, monthly reconciliation
Authorizations, claims, postings and denials are worked every business day and rentals billed on their cycle dates. At month-end the team ties payments to deposits and your ledger and sends a short report on authorization and denial trends.
Software we work in
How much does dme billing cost?
DME billing is commonly priced as a percentage of collections, per claim, or per dedicated biller, and rental-heavy suppliers usually prefer a dedicated biller because the recurring volume is predictable. We quote the model that fits your mix, and engagements run month-to-month. Pricing depends on volume and scope, so we send a custom quote within 1 business day.
What moves the quote
- Monthly new orders and the number of active rentals
- Number of payers and product categories with authorization rules
- Whether documentation collection from prescribers is included
- Volume of open denials and audit requests at the start
Market benchmarks
| Market | Typical range | Source |
|---|---|---|
| US | Dedicated offshore billing staff typically run $8 to $35 per hour all-inclusive, against $40 to $75 per hour for US-based staff | Madras, Acculink, Rose Talent (2026) |
Third-party ranges for orientation, not our prices.
Book a billing audit No setup fee. Month-to-month.
DME billing for your industry
Security and compliance
- HIPAA-trained staff, a signed BAA, and minimum-necessary access to patient records
- MFA on every login, per-client access logs, no PHI on local devices or paper
- Card data is never stored by us; patient payments run through your portal
Full control list on the security page and country rules on the compliance page. Certifications are listed only when held.
Frequently asked questions
How much do DME billing services cost?
Pricing depends on volume and scope, and we send a custom quote within 1 business day. DME billing is commonly priced as a percentage of collections, per claim, or per dedicated biller, and rental-heavy suppliers usually find a dedicated biller the most predictable. As a market reference, dedicated offshore billing staff typically cost $8 to $35 per hour all-inclusive (Madras, Acculink, Rose Talent, 2026).
Do you work inside Brightree?
Yes. We work inside your existing Brightree, Kareo/Tebra or other DME billing system and your payer portals. You keep the subscription, the patient records and the payer enrollments. If you are moving systems, we can support the transition as a separate project.
How do you handle prior authorizations?
Authorization requests are submitted within one business day of a complete order and chased until there is a decision. Each request is logged with the payer, the item, the documents sent and the follow-up dates. Outcomes are reported weekly so you can see which payers and products are being denied and why. Our prior authorization services page explains the call desk behind this.
What documentation do you collect before billing?
The standard written order or physician order, the certificate of medical necessity or equivalent clinical notes, proof of delivery with a patient signature, and any payer-specific forms. Nothing is billed until the checklist for that item and payer is complete, because incomplete documentation is the most common reason for DME denials and audit takebacks.
How do you make sure rental months are not missed?
Every active rental sits on a billing calendar with its start date, cycle date, month count and cap rules. The biller runs the cycle on the due date and the team lead checks the month counts under our Two-Tier Review before submission. Rentals that reach their cap or need a new authorization are flagged a month ahead.
Can you respond to payer audits and documentation requests?
Yes. Additional documentation requests and audit letters are answered before the deadline with a packet built from the documents collected at intake. If a request reveals a missing document, we tell you straight away so you can decide how to respond. We do not give legal advice on appeals; we prepare the file.
Do you bill patients for co-pays and deductibles?
Yes, when you want us to. Statements and balance calls go out under your company name through our patient billing call center, with clear explanations, payment plan options and no card data stored by our agents. Patient payments run through your own payment portal.
Can you reconcile DME revenue to my books?
Yes. The same team that posts remittances reconciles them to bank deposits and your QuickBooks Online or Xero ledger each month. Rental revenue, sales revenue, patient payments and payer takebacks are each explained, so your financial statements match what the billing system says you collected.
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