Audits


71% of MAC Prepayment Audits Paid After Review

Second Quarter Audit Key survey releases several significant findings related to Medicare claims audits.

Medtrade Session Offers Some Good News About Audits

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.

Audit Key Survey Deadline Extended to Sept. 11 

Brightree Report is now available for the second quarter 2017 Audit Key data submissions.

VGM, HIPAAwise Partner for Online Compliance Program

VGM’s van Halem Group will work with maker of HIPAA software to offer HME providers a custom HIPAA-compliance program.

Second Quarter Audit Key Deadline Extended to Aug. 25

AAHomecare reminds providers that the survey doesn’t require individual claims data, but rather cumulative totals on specific audit metrics.

Many HME Categories Still See High Overturn Rates

Latest Audit Key survey shows continued appeal determinations in favor of providers for several mainstay offerings.

California Respiratory Provider Catches a Break on Audits

Home Oxygen Company’s president shares how her oxygen and sleep business earned a reprieve on CPAP and O2 audits.

CareCentrix, Performant to Cut DME ‘Waste, Fraud, Abuse’

Home healthcare management company identifies DME as “high risk areas.”



RAC Reviews Underpayments Made on Group 3 Wheelchair Options

Effort by van Halem Group will see RAC recover incorrect reductions owed to suppliers

CMS Eases Adjudication Process for Serial Claims

DME MACs will change appeals of recurring claims for capped rental items and certain inexpensive and routinely-purchased items.

Next Round of Audit Key Submissions Starts April 17

Tool helps industry collect audit data in order to help make its case for reforming CMS’s audit program; now easier for Brightree users.

respiratory audits under a microscope

Business Solutions

Respiratory Audits: Under the Microscope

As the new RAC comes online, and as the 2017 HHS OIG Workplan is in effect, what can respiratory providers expect in terms of audits, and how should they respond?

Provider Strategy

The RAC is BACK

New changes to the RAC program will start this month. What does that mean for providers?

Q4 Audit Survey Starts Jan. 16

HME Audit Key program urges providers to submit their audit data for Q4 2016; program helps industry better understand audits and advocate reforms.

Medicare Claims: Minimizing Your Audit Exposure

DME Pharmacy

Medicare Claims: Minimizing Your Audit Exposure

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.

HHS OIG Unveils 2017 Work Plan

The plan includes 10 DMEPOS-related investigations, including reports on nebulizers, power wheelchairs, and PAP therapy devices.

Third Audit Key Survey Opens October 15

Providers urged to add their audit data to help demonstrate audit program’s burdensome nature.

Future of HME

Business Solutions

Paving HME's Path

Each fall we turn to the members of HMEB's editorial advisory board to gain their insights into the trends, obstacles, challenges and opportunities that providers should consider as they shape their business strategies for the next several months. This year, many of the board members are telling us that the future will likely be what providers make of it.

Problem Solvers

RAC Audits Version 2: Time to Prepare

As new RAC auditors are coming on board, the instances of RAC audits will increase. Providers must have their ducks in a row.

Audit Denials Increased 6% from Q4 2015 to Q2 2016

Latest HME Audit Key report shows increase audit activity; AAHomecare urges providers to share their data.

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