Running a DME/HME business involves far more than delivering equipment to patients, as any DME/HME business owner can attest, and administrative work is the life blood that runs through every stage of the DME/HME order lifecycle.
In fact, staff often spend a significant amount of time entering data, checking eligibility, requesting documentation, following up on authorizations, routing tasks, and correcting errors, among other administrative necessities.
As order volume grows, these manual processes can become a bottleneck - and a costly one at that.
Here’s the thing, though: DME/HME providers don't necessarily NEED more people to handle administrative work. Providers may need better workflows, made efficient with automation.
DME/HME automation is cool because it reduces manual work, allowing your awesome humans to focus on exceptions and patient/customer service while the bots handle the mundane, rote tasks.
But wait, there’s more:
DME administrative tasks are often repetitive, rules-based, and dependent on information moving from one system or person to another, making them strong candidates for automation.
If you’ve been wanting to move into an automated workflow anyway, administrative tasks are a great place to start.
Keep reading…
The Real Problem With Purely Manual DME Administration
For a small DME/HME practice, tackling all administrative work manually may be OK - however, as demand presents the opportunity for scaling, manual DME administration can quickly become overwhelming.
Even a single order may require multiple employees and systems, especially when information is spread across several platforms (EHRs, billing software, payer portals, etc.).
This would be a lot to handle if everything went smoothly all the time. But DME/HME providers know that’s laughable - exceptions occur, requiring technical human judgment.
Here’s the issue: your employees shouldn't have to manually process EVERY order just because SOME orders require a human.
For practices tackling ALL administrative work manually, delays inevitably occur. No big deal. Well… delays can become big deals. For example, even a simply intake delay can ultimately become a payment delay.
Over time, and multiplied by many orders, the impact can be substantial.
There’s good news here too, though! Some DME administrative tasks are best reserved for your awesome team - but SOME can be handled with excellence by automation designed for your workflow and your EMR.
Consider these tasks:
Top 10 DME Administrative Tasks You Can Automate
This is an important list, okay? Just trust us.
These 10 administrative tasks tend to be fantastic candidates for automation. We’ll provide an overview on each tasks, as well as several resources to dive deeper - but, really, we’re only scratching the surface of possibility each of these tasks provide.
1. DME Order Intake
During this essential launching point in the DME workflow, providers can automate:
- Electronic order intake
- Data extraction
- Patient/order information entry
- Document collection
- Order creation
- Duplicate detection
Bottom line: DME order intake automation validates documentation, eligibility, authorization requirements, and order setup before an order reaches fulfillment or billing. When those checks run at intake, preventable denials never enter the downstream workflow.
2. Data Entry and Information Extraction
Implemented properly, automation can:
- Extract information from referrals, forms, and documentation
- Populate appropriate fields
- Reduce repetitive keyboard entry
- Flag missing or inconsistent information
3. Insurance Verification
Automate workflows for:
- Eligibility checks
- Coverage verification
- Payer identification
- Benefits information
- Documentation of verification results
DME verification automation confirms benefit-level coverage before delivery and rechecks it on every rental and resupply cycle. Plus, automation can surface information and exceptions, allowing staff to handle cases requiring judgment.
4. Documentation Management
Ah yes, the paperwork. Automation, thankfully, can:
- Identify missing documents
- Route documentation to the right team
- Track outstanding requirements
- Trigger follow-up workflows
- Keep orders from sitting idle
5. Prior Authorization Workflows
When it comes to prior authorization support, automation is our favorite team player, often able to:
- Identify orders requiring authorization
- Create tasks
- Route them to the appropriate employee
- Track authorization status
- Trigger follow-ups
- Escalate overdue requests
Prior authorization is the first real gate in the revenue cycle. A claim built on a missing or flawed authorization is dead before it ships, no matter how squeaky clean the rest of the paperwork is. Everything that occurs downstream (the coding, the claim, the cash) depends on the payer already having said yes - and this is why prior authorization automation can be so critical.
6. Task Routing and Work Queues
Often, this is one of the strongest DME automation opportunities we identify.
For example, automated rules can determine:
- Who should receive a task
- What priority it should have
- What department owns it
- When it needs attention
- When it should be escalated
All without the help of a human.
Around this time, we love to mention WIP states in Brightree, and the intensive impact automation can have on them. If you use Brightree, you’ll love this Brightree WIP states automation post.
7. Billing and Claim Preparation
It’s pretty straightforward. Automate:
- Claim generation
- Data validation
- Claim scrubbing
- Missing-information checks
- Submission workflows
- Error identification
Manual billing is one of the biggest time drains in the DME industry. It’s repetitive, error-prone, and hard to scale. Automated DME billing quite literally flips that workflow on its head. It doesn’t just speed things up. It reduces errors, protects revenue, and gives your team back the time they need to focus on more complex, high-value work.
8. Denial and Exception Management
Instead of employees manually monitoring everything, let automation:
- Identify exceptions
- Categorize them
- Route them
- Trigger follow-up tasks
- Track resolution
This seems like a good place to mention this again: automation shouldn't eliminate humans from the process - it should make sure humans spend their time where they're actually needed.
9. Resupply Administration
Automation can help tackle:
- Patient eligibility checks
- Resupply reminders
- Outreach workflows
- Order creation
- Documentation requests
- Follow-up tasks
As providers know, resupply programs are central to DME operations. Thus, when resupply workflows break down, the consequences reach every part of the business… staff time disappears into rework, denials rise, patients wait longer for essential products, you get the picture.
A well-built automated resupply workflow reduces these risks and creates a system that can scale.
10. Reporting and Administrative Monitoring
Automate visibility into:
- Order volume
- Processing times
- Outstanding tasks
- Authorization bottlenecks
- Billing issues
- Denials
- Staff workload
- Resupply opportunities
Where Should You Start?
We get it. That was a long list! And let’s face a stark reality here… not all automation is high-impact automation.
YOU will want high-impact DME automation only.
So, how can you make the decisions when it comes to getting the most out of your automated workflow?
First, Start With High-Volume Tasks
What tasks do your employees perform hundreds of times per week? Make a note of these - they are strong candidates.
Next, Look for Rule-Based Work
Tasks with predictable "if/then" decisions are easier to automate and are often a great place to start.
Third, Prioritize Bottlenecks
Take an honest look at your workflow, and ask:
- Where do orders sit?
- Where are employees waiting on information?
- Where are patients waiting?
- Where do tasks frequently get lost?
- Where are employees constantly checking statuses?
Side note - we actually created a tool called FlowMap that automatically uncovers every manual touch in your workflow FOR you...
Check that out if you’d like to see where your bottlenecks are but don’t want to go searching high and low to find them.
Finally, Leave the Tasks That Require Human Judgment Alone
Automation is best used to handle the predictable work and surface the exceptions. Let your awesome team do more awesome human work. Once again, automation shouldn’t replace your people - it should allow to scale WITHOUT the need to hire.
Is YOUR DME Ready for Administrative Automation?
Are you ready to look into automation, or are you handling everything OK for now? Either answer is fine, but if you’re unsure, we made a little checklist (because why not?!):
Your DME may be ready to explore automation if:
- Employees repeatedly enter the same information
- Orders require frequent manual status checks
- Staff rely heavily on spreadsheets
- Tasks are routinely lost or delayed
- Employees spend hours checking payer portals
- Missing documentation frequently holds up orders
- Authorization follow-up is inconsistent
- Billing errors originate upstream
- Resupply requires significant manual outreach
- Managers don't have visibility into where orders are getting stuck
- You find yourself hiring more staff simply to keep up with volume
If any of these ring true - or you just can’t shake that feeling that automation may be the key to a new level of success for your business - it’s time to take the next step. What might that be? Just keep reading. We’ll tell you.
DME Flow Can Help (This Is Sort Of Our Area of Expertise)
We can tell you two facts: first, DME administrative work isn't going away overnight. Next, order volume and operational complexity can make manual administrative processes increasingly difficult to scale.
So, what’s the answer? (Hint: it’s NOT adding another employee every time volume increases.) On the other hand, strategic DME automation can handle repetitive administrative work while keeping your team working where their expertise matters most.
Start here: find out where your DME's biggest automation opportunities are. To do that, get in touch with a member of our awesome team here at DME Flow. We’d love to start a conversation!
