In the first guidance on how it will handle audits after the Covid-19 public health emergency, CMS offers clarifications on dates of service and the nature of the audits.
- By David Kopf
- Nov 10, 2022
Observation Deck
- By Wayne van Halem
- Jun 01, 2022
Requests for additional documentation will be based on the number of claims a provider has in a category.
Business Solutions
Once again, we proofile 10 trends that will shape the HME industry this year. The far-reaching impact of Covid-19 is undeniable, but it’s not the only factor that will define 2022.
- By David Kopf
- Feb 01, 2022
Problem Solvers
Providers will see an increase in claims audits from Medicare and other funding sources in 2022. Audit expert Wayne van Halem offers insights into what they can expect for this year.
- By David Kopf
- Feb 01, 2022
Podcast
Providers will see an increase in claims audits from Medicare and other funding sources in 2022. Audit expert Wayne van Halem offers insights into what they can expect.
- By David Kopf
- Jan 19, 2022
Both audit program contractors have announced new audits for surgical dressings, enteral nutrition, and parenteral nutrition.
Observation Deck
With the COVID-19 audit pause well behind us, multiple indicators show CMS is quickly resuming audits in a big way. What do HME providers need to know?
- By Kelly Grahovac
- Sep 09, 2021
Observation Deck
- By Kelly Grahovac
- Aug 01, 2021
MACs may now conduct post-payment medical reviews of items and services with dates of service after March 2020.
- By David Kopf
- Jun 03, 2021
Several months ago CMS threatened it would resume its claims audits. Now that is happening and audit expert Wayne van Halem provides the details on what’s happening and what providers need to know.
- By David Kopf
- Apr 07, 2021
OMHA reports to AAHomecare that within a year, the number of pending DMEPOS appeals fell by 51 percent.
- By David Kopf
- Nov 19, 2020
Virtual edition of Provider Compliance Focus Group shared information on TPE audits and recommendations it made to the DME MACs.
- By David Kopf
- Oct 22, 2020
Observation Deck
CMS's announcement that audits would resume Aug. 3 was a shock. Then CMS said it would phase audits back in. What are the details?
- By Wayne van Halem
- Oct 01, 2020
The review from CGS is the result of errors and high payouts for four codes, and should impact claims filed prior to the COVID-19 PHE.
- By David Kopf
- Sep 17, 2020
Audit expert Wayne van Halem joins the HME Business podcast to discuss how CMS will phase its audits back in, and how providers should prepare.
- By David Kopf
- Sep 17, 2020
Observation Deck
The news that CMS planned to resume audits by Aug. 3 took many by surprise. Then CMS said it would resume audits in a phased approach. What are the details and what can providers expect?
- By Wayne van Halem
- Aug 13, 2020
After AAHomecare shared industry concerns over audit resumption, CMS provided a more nuanced and detailed description of how the audit programs will recommence.
- By David Kopf
- Jul 23, 2020
Postponed since March 30, TRP, SMRC and RAC audits will restart next month, as will prior authorization for PMDs and support surfaces.
- By David Kopf
- Jul 16, 2020
Business Solutions
As epidemiologists and public health officials first started warning about COVID-19, some HME providers were already making plans. How has the industry responded to the public health emergency? How have these changes impacted their businesses and patients? How has public policy adjusted? How might all these changes impact the future of the HME?
- By David Kopf
- Jun 01, 2020