HME Business

Oxygen

The proliferation of oxygen generating portable equipment (OGPE), such as transfilling cylinder systems and portable oxygen concentrators (POCs) has been advantageous for both providers and patients alike.

For patients, POCs greatly expands their ability to get around, even flying on airplanes, without having to wrangle heavy tanks. For providers, non-delivery and retail oxygen sales buoyed by demand for POCs have respectively become ways to slash delivery overhead, and to diversify their payer mix to be less dependent on Medicare in the future. Participating in POC retail sales gives oxygen providers the opportunity to offset Medicare reimbursement changes, improve cash flow and gain experience with the various POCs available today.

On the non-retail side of the industry, oxygen providers serving Medicare patients need to be aware of the industry’s growing frustration with audits, which have oxygen claims firmly fixed in their sites. NHIC Corp.’s recently published results of a widespread prepayment review of claims for oxygen and oxygen equipment (HCPCS E1390, E0431 and E0439) in Jurisdiction A says that out of 818 claims submitted by 357 suppliers, the charge denial rate was 46.7 percent. In another example in Jurisdiction D, Noridian Administrative Services reports that the results of a review of the claims for oxygen concentrators, code E1390, identified 4,783 claims of which 3,501 were denied. This is a denial rate of 74 percent.