Full-cycle DME & home health billing: what it covers

The full-cycle workflow

Front end

Eligibility and benefits verification, including rental-versus-purchase coverage rules.
Prior authorization requests for equipment and services that require it.
Collection of physician orders and certificates of medical necessity before delivery or the first visit.

Middle

HCPCS coding for equipment and supplies, and episode-based coding for home health visits.
Claims submission across Medicare, Medicaid, and commercial payers, including recurring rental billing.
Payment posting and reconciliation against contracted or fee-schedule rates.

Back end

Denial management, with attention to documentation-related denials specific to DME and home health.
Appeals filed within payer deadlines, with the supporting order or certification attached.
Patient billing for coinsurance and non-covered items, handled on a clear schedule.

Oversight

Recertification and rental-renewal due-date tracking, so recurring billing doesn't lapse.
A/R aging and denial-rate reporting by equipment category or service line.

Where practices get stuck without it

Equipment ships or a visit happens before the physician order or certificate of medical necessity is on file.
Recurring rental claims lapse because no one tracks the renewal date against the billing calendar.
Documentation-related denials go unworked because pulling the supporting paperwork takes longer than the team has time for.
Coverage rules for rental versus purchase get missed at intake, creating billing disputes with patients later.
Leadership can't tell which equipment category or service line is driving denials without pulling reports manually.

What a RCVRY full-cycle billing team handles

Documentation & Authorization

Confirms the paperwork is in place before delivery or the first visit, not after the claim bounces.

Collects physician orders and certificates of medical necessity up front.
Requests prior authorization and tracks approval status.
Verifies rental-versus-purchase coverage rules before equipment ships.

Recurring & Episode Billing

Keeps rental and episode-based claims on schedule instead of lapsing mid-cycle.

Codes and submits recurring rental and episode-based claims on time.
Tracks recertification and renewal due dates by patient.
Posts and reconciles payments against contracted rates.

Denials, Appeals & Reporting

Works documentation-related denials with the paperwork already on hand.

Flags denials same day and appeals with supporting documentation attached.
Handles patient billing for coinsurance and non-covered items.
Reports A/R aging and denial rate by equipment category or service line.

Who this process is for

DME suppliers managing recurring rental billing across a growing patient base, and home health agencies that need recertification tracking and episode billing handled without pulling clinical staff into paperwork.

Full-cycle DME and home health billing: what it covers