Today's medical devices and durable medical equipment (DME) stakeholders are challenged by an increasingly competitive marketplace due to technology advancements, regulatory and reimbursement changes. Adding to this complexity is also an increased focus on cost-containment. To succeed in this environment, DME enterprises are leveraging HGS's best practices in these areas to help scale and improve agility.

From back-office order intake to inbound customer service and payer collections services, HGS can provide end-to-end, value-driven DME support. Our 15,000 healthcare professionals, including 1,500 registered nurses, employed across our provider and payer business lines, are brand ambassadors for our DME manufacturer and provider clients. These team members bring a distinctive combination of professional certification in their respective specialties, including regulatory expertise, deep domain knowledge, agile workflow innovation, and call center expertise with empathetic and patient-focused service focus.

How We Do It

HGS's unique combination of team and technology work together to optimize patient outcomes. HGS's clinically skilled team members deliver:

  • Triage and Order Intake (Back Office)
    • Document Triage
    • Order Intake
    • Order Entry
      • Patient Demographics
      • Physician Details
      • Soft Payer Selection
  • Inbound Customer Service (Voice)
    • Existing Patient Calls
    • Patient New Orders
    • Referral New Orders
    • Provider Orders
    • Customer Service
  • Customer Qualification Services (Back Office and Limited Voice)
    • Payer Determination
    • Eligibility and Benefits Verification
    • Determine Authorization Requirements
    • Miscellaneous Follow-up Tasks with referrals and patients
  • Self-Pay Follow Up (Voice)
    • Inbound Patient calls
    • Outbound Campaigns
  • Payer Collections
    • RCM for Medical Claims (Medicare included)
    • Electronic Rejections
  • Suspended/ Pre-suspended Billing
    • Authorization
    • Payer Change
    • Rx CMN triage
    • Rx CMN Follow Up with Referrals
    • Documents Follow up with Patients (Medicare)
    • Data Analytics and Analysis
    • Technical Support
    • Patient Benefits Coordination
    • Prior Authorizations
    • Billing support

Our Value

HGS can provide DME services to drive real outcomes, such as:

  • Cost containment, supported by our rightshoring approach and innovative solutions such as intelligent automation and customer analytics
  • Optimized customer experience, with empathetic, quality, real-time, and efficient DME support
  • Dramatically improved collections performance
  • Improved regulatory compliance
  • Omnichannel (voice, chat, text) focus for optimized patient engagement
  • Intelligent automation to relieve providers of the capital and time investment of developing these capabilities in house
Serving Patients on behalf of Providers and Payers
Industry-Leading Compliance
Holistic Provider-Payer Lifecycle Focus