We partner with local pharmacies and independent DME suppliers to eliminate administrative documentation backlogs, resolve old outstanding claims, and secure steady cash flow.
Compatible With Your Core DME Billing & Compliance Infrastructure
Whether you are a community pharmacy or a regional multi-state supplier, our dedicated teams are trained in vertical-specific Local Coverage Determinations (LCDs) and Medicare guidelines.
Compliance management syncing AirView and EncoreAnywhere. We audit patient compliance percentage reports before billing 4-to-15 month rental milestones to eliminate KX modifier denials.
End-to-end prior-authorization packages for custom manual and power wheelchairs (Group 2/3), physical therapy evaluation reviews, face-to-face physician documentation, and continuous order tracking.
High-volume recurring supply protocols for Continuous Glucose Monitors (Dexcom, Freestyle Libre), managing monthly prescription refills, CMNs, and automated physician verification contact.
Select any common DME claim denial code below to inspect the step-by-step audit path our specialists execute to recover cash.
Most Medicare Advantage plans deny CPAP rental claims at month 4 if compliance is not appended. We retrieve data directly from patient compliance portals (AirView/Encore) and re-file with the matching modifier sequences within hours.
Calculate trapped AR recovery and administrative cost savings with dedicated offshore RCM teams.
Stagnant on 60-120+ day aging sheets due to prior-auth and modifier denials.
We integrate smoothly into your active billing system without disrupting daily orders or patient dispatch.
Day 1: Execute formal Business Associate Agreement (BAA) and define scope across your primary billing codes.
Day 2-3: Set up encrypted remote desktop / VPN sessions to Brightree or clearinghouse with zero local file permissions.
Day 4: Run full diagnostic on claims aging past 60/90 days, categorizing errors by CARC/RARC denial reason.
Day 5+: Initiate clean claims submissions, modifier corrections, and bi-weekly recovery reporting dashboard.
We enforce strict administrative, physical, and technical safeguards to keep protected patient health records fully secure and de-identified.
HLZ RCM operates under strict alignment with the federal Health Insurance Portability and Accountability Act (HIPAA) and the HITECH Act guidelines. We process claim audits and appeal files under strict remote encryption channels.
We recommend our partners sanitize aging reports before transmission. Paste a mock billing segment below to test our client-side de-identifier utility instantly.
We provide enterprise-grade, encrypted communications. Reach our administrative, compliance, or leadership divisions across our offices.
Our specialists will audit your de-identified 90-day aging file, identify revenue leaks, and present an overturn blueprint.