Audits


Video: HMEs Comment on OMHA Meeting

VGM members share their thoughts on Appellant Forum proceedings, two-year ALJ delay.

Observation Deck

Flirting with Disaster

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.

AAHomecare Makes Ready for ALJ-Delay Meeting

Feb. 12 discussion will address OMHA’s two-year delay on assigning judges to audit appeals.

Many Providers Frozen by CMS’s ALJ Appeal Delay

Fallout from decision to not assign a judge to new audit appeals for two years felt across healthcare.

New Audits for New Year

Regions A, B, C recovery audit contractors post new reviews.

HME 2014 Preview

2014 Preview

Big Ten

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.

Face-to-Face

Business Solutions

The Face-to-Face Countdown

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.

CMS Lowers Interest Rates

Agency trims 0.5% off Medicare overpayments and sets underpayments to 10.125%.

NHIC Describes CERT Errors on Wheelchair Claims

Sample claims are said to be representative of the most commonly seen mistakes.

HME Competitive Bidding Thrill Ride

Business Solutions

The HME Thrill Ride

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?



Provider Strategy

Broadening Your Product Range

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.

The van Halem Group Adds Senior Consultant

Kelly Grahovac joins audit, compliance consulting firm after a decade with Medicare contractor.

Audits

The 2013 HME Handbook: Audits

Getting Your Ducks in a Row

Senate Finance Hints at Program Integrity Changes for CMS

After soliciting stakeholders’ input a new report from committee summarizes their concerns.

The van Halem Group Hires Additional Medicare Clinician

Jane Naig, RN, CFE, AHFI, joins audit consulting firm as senior clinical consultant.

HHS Could Boost Fraud Reward to Nearly $10 Million

Secretary Sebelius launches proposed rule to boost reward payout for reporting acts of Medicare fraud.

Industry Newsmaker

Bridging Worlds

Wayne van Halem applies 11 years’ experience at Medicare to give providers audit assistance. Getting there has been an interesting journey.

Rock-Solid Documentation

Business Solutions

Steps to Rock-Solid Documentation

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?

2011 RAC Audits Save $488 million of $797 Million Collected

After underpayments and costs, only $488 million goes to trust fund; DME overpayments account for less than 5% of overpayments.

Observation Deck

Medicare's Most Stringent Audits

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.

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