Case Study

Client: Confidential (DME Provider based in the Midwest) Industry: Durable Medical Equipment Services Provided: DME Billing, Denial Management, AR Cleanup, Eligibility Checks Engagement Duration: 6 Months Background Early in 2024, a regional medical equipment provider contacted us because they had a major problem they couldn’t ignore. Although their business was expanding at an alarming rate last year and there were many new patient orders, they were not catching up on their billings. A major problem was that over 30% of their claims were denied, and they were due to errors such as incorrect information or the wrong code.  They had over $280,000 in outstanding payments, with a lot of it overdue by more than 90 days. Payments from Medicare and private insurance companies were also taking too long. Plus, their in-house billing team had experienced high turnover, which left significant gaps in following up on claims and ensuring compliance. They weren’t just losing revenue; they were losing control. The Turning Point The provider knew they needed help from a billing partner that understood the specific challenges of DME billing. Not a generalist. Not someone learning on the job. They wanted a team that could step in, take over the mess, and bring structure, speed, and accuracy to their billing system. At that point, they decided to work with Rapid RCM Solutions. What We Did From the very beginning, our mission was clear: to make their billing smooth, clear, and predictable. Here’s how we achieved it: 1. We Restructured the Billing Workflow Our team started by carefully examining their current billing steps. We checked every step, from getting patient info to sending claims and following up. Then, we created a simpler process, keeping what worked and getting rid of what didn’t. We also started using a checklist before sending bills, especially for items like CPAP machines and wheelchairs. This helped them find and fix paperwork errors before claims went out. 2. We Tightened Eligibility and Authorizations  Many claims got denied because insurance approvals were missing or out of date. To stop this, we had a specific team check insurance before they delivered any equipment. That little change made a big difference in getting claims paid right away. 3. We Took Charge of Denials We also set up a weekly denial report. With this report, the client could see the main denial reasons and work to prevent them.. 4. We Rolled Up Our Sleeves on Aging AR Our billing experts dug into every unpaid bill. They put the most important ones first, sent corrected claims, and chased down payments from insurance companies. It wasn’t always exciting, but it definitely brought in the money. 5. We Helped Staff Stay on Top of Compliance DME billing rules change constantly. We held short virtual sessions with the provider’s team to walk them through updates, like Medicare’s CMN requirements and proof-of-delivery guidelines. That helped prevent future delays and rejections. The Results After six months of consistent effort, the numbers told the story: Metric Before Rapid RCM After 6 Months Denial Rate 30% 7.5% Claims Paid in 30 Days 38% 81% A/R Over 90 Days $280,000+ $74,000 Monthly Collections $145,000 $210,000 Average Days in A/R 72 days 36 days In Their Words “We’re so glad we partnered with Rapid RCM for our billing. Their DME billing team was incredibly competent. They focused on real work and got us real outcomes.” — Director of Operations, Confidential Client Why It Worked The DME space has its own billing challenges. You’re dealing with complex documentation, payer-specific rules, and frequent audits. This is why our approach worked: we didn’t just send claims faster. We understood the unique challenges, built better systems, and took action early. This is what made the difference: Knowing the Business: Our team had direct experience with medical equipment billing codes, required forms, and how different insurance companies handled things. Quick Start: We didn’t drag our feet. We fully onboarded and took over their billing in under a month. Open Talks: Weekly calls, clear reports, and a single point of contact made sure everyone stayed connected and knew what was happening. Final Thoughts Medical billing doesn’t have to be a black hole of lost revenue—especially in the DME world, where every claim comes with extra layers of complexity. With the right billing partner, you can move from reactive firefighting to proactive cash flow management. That’s what this provider did—and the results speak for themselves. If you’re dealing with denied claims, aging AR, or staff overwhelmed by documentation rules, we’re ready to help you turn it around—just like we did here.