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Durable Medical Equipment, Prosthetics,Orthotics, and Supplies Medicare Competitive Bidding Program: Temporary Gap Period Unless you’re a healthcare worker using durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) or are a home healthcare company, you probably have no idea what Medicare’s DMEPOS Competitive Bidding Program (CBP) is or how it affects…
CMS proposed a number of payment policies to durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) from July 2014 till date. Here’s the historical payment rules of each year. CMS Proposed Polices and Payments rates for End-Stage Renal Disease providers for CY 2015 On July 2, 2014, the Centers for…
Getting your DME can be a challenging and time consuming process. Using the following information can help to make the process go a little faster, and reduce the chance of denial of coverage by your health insurance carrier. It is important for you to take charge of getting your DME. …
Dual Eligible Beneficiaries may face special obstacles when they try to access services, such as durable medical equipment, that is covered to varying degrees by both Medicare and Medicaid. The Integrated Care Resource Center recently released a briefing titled “Facilitating Access to Medicaid Durable Medical Equipment for Dually Eligible Beneficiaries in…
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…
Medical devices are a fast-growing segment in the health care industry. The demand for devices is accelerating from two particular areas, emerging foreign markets where the devices are relatively new, and in the U.S. with its aging population. Medical devices manufacturers face unique challenges when compared to other equipment manufacturers. Not…
A frequent question arise from every physicians is how they can negotiate better Payer contract. It’s not easy negotiating the best Payer contract terms requires a significant amount of preparation and work along with good negotiation strategies. In addition, there are many specialty specific and practice specific nuances that physicians…