Start with the small stuff
I read a comment the other day that had nothing to do with the HME industry, except that it kind of did. It was "start with the small stuff and the big stuff will follow."
If you put that quote in the context of audits/denials, that's an apt statement. We frequently report on various audit issues: the workload, the inconsistencies, the occasional absurdities. Providers are quick to complain about audits, and rightly so. What many providers are not so quick to do is fight audits or denials, especially on the low dollar stuff.
But if you don't fight the small stuff, it adds up to bigger stuff. It creates high percentages of denials that CMS then uses to justify ongoing reviews. And who wants that?
And how many times do we see "did not respond to request for documentation" as a reason for denials.
I know this lack of response, where it happens, is a concern for many of the consultants, attorneys and Walt Gorskis we talk to each week.
I get it and they get it. It costs time and money to respond to requests, appeal denials. A comment that appeared on our website from one provider says he spends about 30 cents of every dollar he earns on billing and collections.
But, if you look at the bigger picture, I think the value of fighting back outweighs some of the cost and aggravation. In other words, sweat the small stuff.
I also know that there's nothing HME providers love more than a good story about CMS being wrong.