Audits


CMS Publishes Post-PHE Audit Guidance

In the first guidance on how it will handle audits after the Covid-19 public health emergency, CMS offers clarifications on dates of service and the nature of the audits.

RAC Audits Will Now Account for Product Volume

Requests for additional documentation will be based on the number of claims a provider has in a category.

abstract covid virus graphic

Business Solutions

15th Annual Big 10

Once again, we proofile 10 trends that will shape the HME industry this year. The far-reaching impact of Covid-19 is undeniable, but it’s not the only factor that will define 2022.

Problem Solvers

Assessing CMS's Audit Ramp-up

Providers will see an increase in claims audits from Medicare and other funding sources in 2022. Audit expert Wayne van Halem offers insights into what they can expect for this year.

Podcast

Prepping for CMS’s Audit Ramp-up

Providers will see an increase in claims audits from Medicare and other funding sources in 2022. Audit expert Wayne van Halem offers insights into what they can expect.

SMRC and RAC Conducting New Audits

Both audit program contractors have announced new audits for surgical dressings, enteral nutrition, and parenteral nutrition.

Observation Deck

Preparing for the Next Surge in Claims Audits

With the COVID-19 audit pause well behind us, multiple indicators show CMS is quickly resuming audits in a big way. What do HME providers need to know?

Observation Deck

Preparing for the Next Surge in Claims Audits

MACs’ Post-payment Review Broadened

MACs may now conduct post-payment medical reviews of items and services with dates of service after March 2020.

The Return of Medicare Claims Audits

Several months ago CMS threatened it would resume its claims audits. Now that is happening and audit expert Wayne van Halem provides the details on what’s happening and what providers need to know.



Audits: Expert Shines Light on Worrying New Trends

Top-line audit concern includes HHS OIG adding PAP supplies to Its workplan. Wayne van Halem will discuss several new, worrying audit developments and how to prepare for them in Dec. 11 webinar.

Podcast

HHS OIG Adds PAP Supplies to Its Workplan — Again

Sleep equipment providers risk facing costly six-year lookback audits in this new addition to OIG's workplan. How should they prepare?

GF Health Earns ISO 13485:2016 and MDSAP Certification in U.S. Locations

The medical device manufacturer says the certification will allow for more growth in the market and improved efficiency.

game plan

Business Solutions

A Game Plan for Six-Year Lookbacks

CMS's six-year lookback audits represent a daunting challenge for HME providers, but there are steps they can take to deal with them.

RAC Approved to Audit Diabetes Test Strips

Performant will only review HCPCS code A4253 and claims paid date must be within three years before the Additional Documentation Request.

Wayne van Halem

Provider Strategy

A Scary New Trend: Six-Year Lookback Audits

Understanding another 'new normal' for HMEs from HHS OIG.

Home Oxygen Company Earns Audit Reprieve

California respiratory and sleep provider notches its fourth 12-month break from TPE audits.

Industry Hits Capitol Hill with Full Agenda

AAHomecare facilitates in-person meetings between lawmakers and industry advocates in Washington, D.C.; coordinates virtual fly-in for providers to remotely assist lobbying push.

HMEB Podcast Episode 004 Now Online

Latest installment in HMEB’s quickly growing podcast survey examines breast cancer legislation and six-year lookback audits.

strategy

Business Solutions

Setting a Smart Strategy for 2019

Are you setting the right strategy for 2019? This marks our 11th annual survey of the 10 key trends that will impact the home medical equipment industry the most during the New Year. In this year's list, larger healthcare and retail trends could impact HME more than anticipated. As a result, this installment of the Big 10 list is a must-read.

HME Business Podcast