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How To Make Your CLAIM AUDIT Look Like A Million Bucks? HME businesses face increasing numbers of pre- and post-payment audits, which can be very stressful and costly events. Without a sound strategy for maintaining accurate and retrievable documentation, an audit request can disrupt operations and put your organization at…
Common Documentation Errors Identified by CERT & RACS. The Centers for Medicare & Medicaid Services calculates the Medicare Fee-for-Service (FFS) improper payment rate through the CERT program. Each year, CERT evaluates a statistically valid stratified random sample of claims to determine if they were paid properly under Medicare coverage, coding, and…
The Centre for Medicare and Medicaid Services offers extensive and detailed DME Medicare documentation guidelines in general, as well as other guidelines for documentation that can be found in Local Coverage Determinations and National Coverage Determinations. Durable Medical Equipment billing continues to scrutinized by Medicare and other Commercial Carriers, so…
On June 11, 2018, the Centers for Disease Control and Prevention (CDC) released the FY 2019 ICD-10-CM code changes. There are 473 code changes, including 279 new codes, 143 revised codes, and 51 deactivated codes. These codes are to be used from October 1, 2018 through September 30, 2019. The total…
What is Medical Credentialing? For many licensed medical professionals, Medical Credentialing is known as 1) “the process of becoming contracted with insurance companies”, or 2) “the process of getting on insurance panels”, or 3) “what you need to do to be able to accept insurance.” If the process of credentialing is…
Digital Marketing has always been about connecting with your audience in the right place and at the right time. Today, that means you need to meet them where they are already spending time on the internet. There was a time when developing and implementing marketing campaigns meant running ads on…
Insurance companies provide coverage for care, items, and services that they deem to be “medically necessary”. Medical necessity is one of the most common reasons that insurers deny behavioral health claims. It is possible to get this type of denial overturned, but to do so; there are a few essential steps to…
Cyber security is vital for businesses in every sector today. However, it’s particularly important for those in the healthcare sector. There are several reasons why businesses in this arena can’t afford to put off cyber security measures and why tomorrow may be too late to do what you should have…
The DME industry, as we know it today, has been around for about 40 years. It is a young industry. For the first 30 years of its existence, there was little government oversight on the DME industry. This has changed. Today, the DME industry is caught in a “perfect…
Mobile Technology has been one of those trends that have taken the business world by storm. Mobile device penetration has been rapid and monumental. In an industry facing reimbursement cuts, ever-evolving regulations and increased customer demand, DME executives are constantly searching for ways to streamline workflow and improve revenue. In…
