New Brightree Tool Supports HME Industry Efforts to Collect Data on Medicare Audits

The next HME Audit Key data submission period, covering the time period through the 2nd Quarter of 2017, is set to open on July 17.  Even if you haven’t previously participated, you can still take part starting with this round.  HME suppliers of all sizes and specialties are encouraged to join this campaign to build

Read the full article »

Are you prepared for the new nationwide PAR?

By Kay Koch, OTR/L, ATP Rehab Clinical and Education Consultant Beginning July 17, 2017, K0856, single power option and K0861 multiple power options, Group 3 Power Mobility Devices will be subject to Prior Authorization Review (PAR) nationwide. Prior to this date, the PAR program has been in place since September 1, 2012 and included all POV and

Read the full article »

Correct Coding – Leg Rest and Foot Plates/Foot Platforms bundled into HCPCS E1012

By: Kay Koch, OTR/L, ATP, Rehab Clinical and Education Consultant This DME MAC Joint Publication was posted on June 22, 2017. It is a good reminder to those who are billing the E1012 center mount elevating leg rest on power wheelchairs. Recently it has come to the attention of the DME MACs that suppliers are billing separately for footplates

Read the full article »

RAC AUDIT ALERT: Power Mobility Devices

Performant Recovery, National RAC for DME, Home Health and Hospice has released another issue to the approved issues log. Power Mobility Devices not subject to the PA demonstration are under complex review, effective June 6, 2017. Claims will be reviewed for Medical Necessity and Documentation Review. Visit Performant Recovery’s website to review this and all other approved issues.

The Cost of Compliance – An impassioned plea to be proactive

By: Wayne H. van Halem To start, when I say compliance I am speaking directly to being compliant with government laws and regulations when treating patients receiving services from government or private payors. This isn’t licensure or accreditation, but a reimbursement compliance program – where your greatest risk is. I know this is not a

Read the full article »

Potential ventilator overpayments identified by the OIG

In September 2016, the OIG released a report titled “Escalating Medicare Billing for Ventilators Raises Concerns“. The report findings were a result of the 2016 OIG Work Plan that identified ventilators as a target for review. The OIG investigation looked to identify (1) billing trends and factors associated in the increase in billing of ventilators

Read the full article »

Schedule a consultation at Heartland

The van Halem Group (vHG) has announced something new for Heartland attendees this year. Multiple vHG representatives will be on-site and available for personal consultations throughout the day Tuesday through Thursday. Whether you have questions about a specific situation you are experiencing or want to learn how to protect and safeguard your business from compliance issues,

Read the full article »

RAC Announces it will review Underpayments made on Group 3 Wheelchair options

On May 17, 2017, Performant Recovery, the National DMEPOS RAC announced that it will begin to recover underpayments, or incorrect reductions owed to suppliers, for wheelchair accessories and cushions for Group 3 complex power rehab wheelchairs. Section 2 of the Patient Access and Medicare Protection Act (PAMPA) mandates that adjustments to the 2016 Medicare fee

Read the full article »