DME Billing for Call Centers: Codes, Documentation & Order Process
In today’s fast-paced healthcare environment, Durable Medical Equipment (DME) billing has become an essential and specialized task. As DME providers scale their services, many outsource their front- and back-end operations to call centers and BPO teams. However, without proper training in billing codes, documentation, and order workflows, teams may struggle with claim denials and revenue loss.
This guide simplifies DME Billing for Call Centers, helping your team understand how to navigate ICD-10 codes, process orders accurately, and ensure compliance
Why DME Billing Matters for Call Centers
Call centers are often the first point of contact for patients, providers, or DME companies. Your team handles:
Intake of patient information
Order documentation
Insurance verification
Pre-billing data
When done right, this improves the speed and success of DME claims. When done wrong, it results in claim rejections, denials, or audits.
Understanding ICD-10 Codes for DME
Every DME claim needs to be linked to a valid diagnosis code (ICD-10) that supports medical necessity. Here’s what call center agents need to remember:
Match the ICD-10 code to the prescribed equipment
Cross-reference diagnosis with HCPCS codes
Ensure providers include the correct clinical notes
Example:
DME Item: Knee brace
ICD-10 Code: M17.11 (Unilateral primary osteoarthritis, right knee)
Incorrect codes can delay or deny claims. BPO staff must be trained to flag mismatches early.
Proper Documentation Checklist
Call center agents should ensure each order includes:
Face-to-Face (F2F) Encounter Note
Written Order Prior to Delivery (WOPD)
Detailed Written Order (DWO)
Proof of Delivery (POD)
Signed CMN or Certificate of Medical Necessity, if applicable
Make sure all documents are legible, signed, and dated — CMS audits often catch missing or vague documentation.
Order Intake & Processing Flow
Here’s a typical DME order flow that call center agents and BPOs should follow:
Receive Order from Provider or Patient
Verify Insurance eligibility and coverage
Request Required Documents (Rx, notes, etc.)
Assign ICD-10 & HCPCS Codes
Input into Billing Software / EMR
Route to Billing Team or DME Company
Use CRM tools and checklists to ensure every step is tracked and confirmed.
Common Pitfalls to Avoid
Using outdated or incorrect ICD-10 codes
Submitting incomplete documentation
Skipping eligibility verification
Delivering equipment before WOPD is completed
Failing to confirm provider signatures
Avoiding these issues increases claim acceptance and reduces financial losses for DME providers.
How This Helps DME Owners
DME companies rely on call centers to streamline operations. A well-trained team that understands DME billing leads to:
Fewer denials
Faster reimbursements
Better patient satisfaction
Increased business trust
DME owners looking to outsource want reliable partners who know how to get paid — not just take calls.
Bonus: Educating U.S. Patients on Insurance
Call center agents can also assist patients directly, helping them understand what DME they’re eligible for under Medicare or private insurance. This improves compliance and patient loyalty.
Final Thoughts
DME Billing for Call Centers is no longer just about answering calls — it’s about adding value. From correct coding to complete documentation, BPO teams can become a crucial part of the DME revenue cycle.
Want to train your team or outsource your DME tasks to billing experts?
👉 Contact Us at The Dorsum to learn more.