Observation Deck
OMHA’s decision to delay assigning ALJs to audit appeals for up to more than 24 months does far more damage than holding recouped reimbursement in limbo. Even a cursory investigation of the latest developments make it patently clear that these delays may put more Medicare providers out of business than any other issue facing healthcare companies today.
- By Edward Vishnevetsky
- Feb 13, 2014
AAHomecare’s Ryan tells OMHA’s Griswold that ALJ delay has put providers in ‘crisis mode’ and a fix is needed fast.
- By David Kopf
- Feb 13, 2014
Feb. 12 discussion will address OMHA’s two-year delay on assigning judges to audit appeals.
- By David Kopf
- Jan 31, 2014
Fallout from decision to not assign a judge to new audit appeals for two years felt across healthcare.
- By David Kopf
- Jan 23, 2014
Regions A, B, C recovery audit contractors post new reviews.
- By David Kopf
- Jan 09, 2014
Business Solutions
The rollout of CMS's face-to-face requirement has been a non-stop series of delayed dates and constant confusion over what those dates actually mean. Now providers are not only wondering how they can convince legions of referral partners to comply, but what exactly is required and when. We talk to the experts to shed some light on the situation.
- By David Kopf
- Jan 01, 2014
2014 Preview
The seventh installment of our annual forecast of key trends, obstacles and opportunities facing the HME provider industry shows that the coming year is one fi lled with challenges, but also chances for providers to reinvigorate their revenues. We examine what’s in store for the next 12 months and how providers should prepare.
- By David Kopf
- Jan 01, 2014
Agency trims 0.5% off Medicare overpayments and sets underpayments to 10.125%.
- By David Kopf
- Oct 31, 2013
Sample claims are said to be representative of the most commonly seen mistakes.
- By Laurie Watanabe
- Oct 24, 2013
Provider Strategy
With audits and decreasing reimbursement levels diverting your attention, it can seem more and more difficult to keep the focus on providing the best in patient care, but there are things you can do and products you can add to your “fleet” that will improve your business while enhancing patient care.
- By Brian LaDuke
- Oct 01, 2013
Business Solutions
HME providers have been on a roller coaster over the past few years. What's in store for them from a regulatory and business standpoint in 2014, and how should they shape their business strategies to survive and succeed?
- By David Kopf
- Oct 01, 2013
Kelly Grahovac joins audit, compliance consulting firm after a decade with Medicare contractor.
- By David Kopf
- Jun 06, 2013
The 2013 HME Handbook: Audits
After soliciting stakeholders’ input a new report from committee summarizes their concerns.
- By Michael Reinemer
- May 02, 2013
Jane Naig, RN, CFE, AHFI, joins audit consulting firm as senior clinical consultant.
- By David Kopf
- May 02, 2013
Secretary Sebelius launches proposed rule to boost reward payout for reporting acts of Medicare fraud.
- By David Kopf
- Apr 25, 2013
Industry Newsmaker
Wayne van Halem applies 11 years’ experience at Medicare to give providers audit assistance. Getting there has been an interesting journey.
- By David Kopf
- Apr 04, 2013
Business Solutions
As providers continue to find themselves swimming in a sea of post- and pre-payment Medicare audits, they know flawless documentation is their best life line. What are the key ways they can implement strong documentation?
- By Cindy Horbrook
- Apr 01, 2013
After underpayments and costs, only $488 million goes to trust fund; DME overpayments account for less than 5% of overpayments.
- By David Kopf
- Feb 07, 2013
Observation Deck
In many cases, especially for power mobility devices (PMDs), a provider may not know whether a file meets all of the requirements until an audit occurs, due in part to the subjectivity of medical necessity documentation review.
- By Paul Komishock
- Feb 01, 2013