Audits


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.

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.

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.

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.

AAHomecare Continues Call for Provider Data

Providers urged to participate in the DME Cost Study and 2Q Audit Key survey to bolster industry’s case for bidding, audit reforms.

Providers Need to Learn About Key Audit Changes

Webinar from senior Van Halem Group expert Kelly Grahovac to identify new audit trends, and explain how providers should prepare.

Audit Key: MAC Prepayment Audits Averaged 12% for New Patients

First round of data from Fourth Quarter of 2015 yield a variety of results that take first step in documenting impact of audits on HME providers, patients.

Accreditation and Audits

Two accreditation experts discuss the relationship between accreditation and audits.

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