Performant will only review HCPCS code A4253 and claims paid date must be within three years before the Additional Documentation Request.
- By David Kopf
- Jun 20, 2019
Provider Strategy
Understanding another 'new normal' for HMEs from HHS OIG.
- By Wayne van Halem
- Jun 01, 2019
California respiratory and sleep provider notches its fourth 12-month break from TPE audits.
- By David Kopf
- May 30, 2019
AAHomecare facilitates in-person meetings between lawmakers and industry advocates in Washington, D.C.; coordinates virtual fly-in for providers to remotely assist lobbying push.
- By David Kopf
- May 23, 2019
Latest installment in HMEB’s quickly growing podcast survey examines breast cancer legislation and six-year lookback audits.
- By David Kopf
- Mar 14, 2019
Business Solutions
Are you setting the right strategy for 2019? This marks our 11th annual survey of the 10 key trends that will impact the home medical equipment industry the most during the New Year. In this year's list, larger healthcare and retail trends could impact HME more than anticipated. As a result, this installment of the Big 10 list is a must-read.
- By David Kopf
- Jan 01, 2019
Editor's Note
DMEPOS represents an outsized share of audit appeals at ALJ. Providers must take action first.
- By David Kopf
- Dec 01, 2018
Observation Deck
How to approach the CGS/Noridian letter and the '60-Day Rule.'
- By Jeffrey S. Baird, Wayne van Halem
- Dec 01, 2018
Starting Nov. 1, a demonstration project that lets providers work with QIC over the phone to reopen claims at ALJ will grow to incorporate Jurisdictions A and B.
- By David Kopf
- Oct 23, 2018
June's HHS OIG report on PAP resupply overpayments has resulted in Medicare contractors asking some sleep providers to review claims going back over six years.
- By David Kopf
- Oct 04, 2018
Business Solutions
Each October we ask the members of HMEB’s editorial advisory board to share their insights into the trends, obstacles, challenges and opportunities that providers will likely encounter over the next several months. This year, the board members are pointing to several developments that providers might not have on their radars.
- By David Kopf
- Oct 01, 2018
An appellate decision from the Fifth Circuit Court of Appeals offers good news for providers caught in the ‘no man’s land’ between reconsideration and the Administrative Law Judge.
- By Jeffrey S. Baird
- Jul 12, 2018
New report from HHS OIG says claims for replacement positive airway pressure device supplies didn’t comply with Medicare’s requirements.
- By David Kopf
- Jun 14, 2018
Enteral Nutrition tops the list in data gleaned from Fourth Quarter 2017 Targeted Probe and Educate audits.
- By David Kopf
- May 10, 2018
Audit contractor Noridian tells provider it has closed its audit file thanks to it squeaky-clean performance in Round 1 of the Targeted Probe and Education Audit process
- By David Kopf
- Apr 26, 2018
Attendees to VGM event will be able to discuss regulations, reimbursements and audits with CMS representatives.
- By David Kopf
- Apr 05, 2018
Prototype of the audit survey data shows a variety of ways providers can compare their audit performance to the industry.
- By David Kopf
- Feb 01, 2018
Industry audit survey will go from quarterly to half-year reports, includes new report benefit.
- By David Kopf
- Jan 04, 2018
Problem Solvers
What can respiratory providers expect from a new audit program during 2018, as well as respiratory audits carrying over from last year?
- By David Kopf
- Jan 01, 2018
Audit expert Wayne van Halem explains why respiratory providers need to pay close attention to Medicare's new TPE audits.