Editor's Note
DMEPOS represents an outsized share of audit appeals at ALJ. Providers must take action first.
- By David Kopf
- Dec 01, 2018
Observation Deck
How to approach the CGS/Noridian letter and the '60-Day Rule.'
- By Jeffrey S. Baird, Wayne van Halem
- Dec 01, 2018
Starting Nov. 1, a demonstration project that lets providers work with QIC over the phone to reopen claims at ALJ will grow to incorporate Jurisdictions A and B.
- By David Kopf
- Oct 23, 2018
June's HHS OIG report on PAP resupply overpayments has resulted in Medicare contractors asking some sleep providers to review claims going back over six years.
- By David Kopf
- Oct 04, 2018
Business Solutions
Each October we ask the members of HMEB’s editorial advisory board to share their insights into the trends, obstacles, challenges and opportunities that providers will likely encounter over the next several months. This year, the board members are pointing to several developments that providers might not have on their radars.
- By David Kopf
- Oct 01, 2018
An appellate decision from the Fifth Circuit Court of Appeals offers good news for providers caught in the ‘no man’s land’ between reconsideration and the Administrative Law Judge.
- By Jeffrey S. Baird
- Jul 12, 2018
New report from HHS OIG says claims for replacement positive airway pressure device supplies didn’t comply with Medicare’s requirements.
- By David Kopf
- Jun 14, 2018
Enteral Nutrition tops the list in data gleaned from Fourth Quarter 2017 Targeted Probe and Educate audits.
- By David Kopf
- May 10, 2018
Audit contractor Noridian tells provider it has closed its audit file thanks to it squeaky-clean performance in Round 1 of the Targeted Probe and Education Audit process
- By David Kopf
- Apr 26, 2018
Attendees to VGM event will be able to discuss regulations, reimbursements and audits with CMS representatives.
- By David Kopf
- Apr 05, 2018
Prototype of the audit survey data shows a variety of ways providers can compare their audit performance to the industry.
- By David Kopf
- Feb 01, 2018
Industry audit survey will go from quarterly to half-year reports, includes new report benefit.
- By David Kopf
- Jan 04, 2018
Problem Solvers
What can respiratory providers expect from a new audit program during 2018, as well as respiratory audits carrying over from last year?
- By David Kopf
- Jan 01, 2018
Oct. 24 presentation from van Halem Group duo will examine the ways in which CMS is changing the way CMS is performing some audits -- some for the better.
- By David Kopf
- Sep 21, 2017
Brightree Report is now available for the second quarter 2017 Audit Key data submissions.
- By David Kopf
- Aug 31, 2017
AAHomecare reminds providers that the survey doesn’t require individual claims data, but rather cumulative totals on specific audit metrics.
- By David Kopf
- Aug 16, 2017
Latest Audit Key survey shows continued appeal determinations in favor of providers for several mainstay offerings.
- By David Kopf
- Jul 13, 2017
DME Pharmacy
Pharmacies selling Medicare reimbursable DME items will eventually be audited. We examine how to protect your claims and how documentation helps minimize your risk of having a claim recouped.
- By Joseph Duffy
- Dec 01, 2016
The plan includes 10 DMEPOS-related investigations, including reports on nebulizers, power wheelchairs, and PAP therapy devices.
- By David Kopf
- Nov 17, 2016
Providers urged to add their audit data to help demonstrate audit program’s burdensome nature.
- By David Kopf
- Oct 06, 2016