Reimbursement


PECOS Warnings Are Back on DME Claims

CMS warns that future claims from prescribers not in PECOS will not be paid.

Funding 2012

New Codes, A New NCB Round & Hello, Demo!

Analysis and expertise on 2012 funding issues by Claudia Amortegui, president, The Orion Group.

PMD Demonstration Project Under Fire from Providers, Consumers

Medicare prepayment reviews slated to begin Jan. 1 in seven states with high PMD usage.

CMS Revises Repair & Replacement Policy for Competitively Bid Items

New Fact Sheet details rules for billing for parts and repairs to DME under competitive bidding.

NGS Announces Results of Support Surfaces Prepayment Probe

Jurisdiction B DME MAC reports high error rate in claims it examined.

CMS to Scrutinize PMD Claims in 2012 Demonstration Project

Medicare claims in seven states will be subjected to prepayment review and prior authorization.

Urological Supplies Prepayment Review to Continue in Jurisdiction B

National Government Services review concerns Medicare claims for code A4353.

NGS Discontinues Second Overpayment Demand Letter

New policy eliminates second warning regarding refund requests.

Funding Essentials

Power Mobility Device Options: Coding Q&A



Automotive Accessibility

Funding Essentials: The Reimbursement Side of Crash-Test Standards

Providers Reminded About Proper Electronics Billing

Clarification document from four DME MACs gives examples of proper procedures for power chair electronics billing.

NGS: Proper Info Needed for Redeterminations

NGS reminds providers what information is needed for redetermination requests.

Medicare Contractors to Attend Medtrade

Attendees to include reps from four DME MACS, NSC, CEDI and CBIC.

Providers Reminded of Beneficiary Authentication Info When Using IVR

Information is needed regardless of type of inquiry.

CMS Requests More Info on Proposed California Medicaid Cuts

On Sept. 28 deadline, CMS asks for additional data on how beneficiaries' access would be impacted.

HHS Releases Final Rule for Medicaid Audit Program

New RAC program, to start Jan. 1, is modeled on controversial Medicare program.

Ops Management

Overcoming the Challenges of Adapting to Increasingly Lower Reimbursement

The reality of doing business in our industry in 2011 is that it is no longer enough to run a competent company that works hard to do a good job for patients.

NCART Medicaid Summit Planned for November

St. Louis event to help providers share best practices, strategies and updates.

Jurisdiction B to Continue K0823 Prepayment Reviews

Denial rate for Group 2 standard power chairs in quarter two was 77 percent for examined claims, National Government Services says.

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