Audits


Audits

Business Solutions

Keeping Watch on Audits

Audits continue to play an unsavory role in the day-today lives of HME providers, and that role is one that is constantly shifting as HHS and its contractors emphasize different aspects of their program integrity efforts. We look at coming and developing trends in audits, and ask the experts how providers should plan and prepare.

Accreditation and Audits

Two accreditation experts discuss the relationship between accreditation and audits.

Audit Key’s Date for Entering First Quarter Data Fast Approaching

Providers can submit their information into the special audit tracking program starting on April 15.

Editor's Note

More of a Bad Thing

The President's proposed 2017 budget doubles down on the wrong ideas.

AAHomecare to Detail Legislative, Regulatory Priorities

National HME association will outline its key advocacy objectives for the year at Medtrade Spring’s Washington Update.

Audit Key Extends Entry Deadline

Providers have until Feb. 26 to enter their fourth quarter audit data into the industry audit-tracking site.

Medicare Releases Final Rule on Overpayments

Rule clarifies when providers must report and return self‑identified overpayments.

Audit Key Goes Live

Providers urged to register for program that is collecting the hard data that will help make a strong case for reforming CMS’s audit program.



The Best Offense for Appeals: A Good Defense

One of the best strategies against an audit and possible appeal is prevention. Here are some key steps.

Audit Appeal

Business Solutions

Winning the Audit Appeal Game

Medicare claims audits do not stop at claims being recouped. If anything the process just begins. As providers have realized early on in the process, many audits can and should be appealed. We talked to various experts to outline the appeals process and understand how providers can improve their chances through the various steps.

Industry Forecast

HME Business 2016 Annual Industry Forecast

2016 Big Ten

Each year HME Business profiles 10 upcoming trends that will help define the industry over the next 12 months. To be certain, competitive bidding will be one of those factors. Others challenges include audits and protecting complex rehab. But 2016 also offers opportunities, as well, such as retail sales and revenue diversification.

Audit Key Goes Live in 2016

Providers encouraged to register for program that will help accumulate data that industry will use to reform CMS’s audit program.

Editor's Note

Built to Fail

Quality was not 'job one' when CMS designed its audit program — which need serious and immediate retooling.

Some States See Post-Pay Audits on Parenteral Nutrition, Ventilators

With high denial rates in Jurisdiction A, it is likely the audits will expand.

Smart Strategy

Business Solutions

Setting a Smart Strategy

Providers face many challenges, but it’s time to turn the tables. Various experts assess the market and help determine how providers can set a smart course for success.

Provider Strategy

esMD: Your Secret Weapon

CMS offers a key methodology to help providers follow-up on documentation requests for audits, PMD prior authorization and appeals.

Average Audit Appeal Processing Time Surges to 714 Days

AAHomcare analysis shows a whopping 2122% increase in DMEPOS-related audit appeals over past 8 years.

Mont. Providers Urged to Attend SBA Hearings

July 21, 23 forums will give local HME providers an opportunity to publicly voice their concerns regarding audits, competitive bidding expansion.

CMS Pays $1.3 Billion to Settle Hospital Claims

CMS settles with 1,900 on audited claims stuck in OMHA. AAHomecare asks, ‘Is there anything in sight for DMEPOS?’

Senate Finance Committee Passes Audit Reform

Audit & Appeal Fairness, Integrity, and Reforms in Medicare Act aims to add transparency, oversight to audits and appeals process.

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