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audits

NewsPoll: Providers receive some far-out denials

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01/16/2015

YARMOUTH, Maine – Imagine having a claim denied because Medicare doesn’t like the handwriting on the prescription.

A good news week

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Friday, January 9, 2015

I blogged last week about how the industry saw some good progress, but no resolutions, on its top issues of competitive bidding and audits in 2014.

Well, it’s off to a good start in 2015.

Groups set stage for action on audits

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12/31/2014

WASHINGTON – Even though the American Hospital Association (AHA) lost its bid to get a court to intervene in a huge backlog of appeals of Medicare claims, the lawsuit keeps the controversial program in the spotlight, industry stakeholders say.

Rip Van Winkle? Not so much

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Tuesday, December 30, 2014

You’d think, after taking a three-month maternity leave, that I’d I feel a little bit more Rip Van Winkle about the HME industry.

DME MAC launches manual wheelchair review

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12/24/2014

INDIANAPOLIS – So far, few providers in Jurisdiction B seem to be affected by a recent prepayment review for manual wheelchair bases, including adult tilt-in-space models (E1161).

Expect more aggressive audits

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12/01/2014

ATLANTA – Medicare has gone from pay-and-chase to not letting the money out, says healthcare attorney Denise Leard.

The result is more—and meaner—audits, she said during a session at Medtrade in October.

Appeals backlog soars, solutions don’t appear imminent

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11/14/2014

WASHINGTON – Less than a year after a massive appeals backlog at the Administrative Law Judge (ALJ) level first came to light, that backlog has nearly tripled.

Bills get bump from fly-in

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09/16/2014

WASHINGTON – A legislative fly-in on Sept. 10 spearheaded by The MED Group and supported by AAHomecare resulted in 100 meetings with lawmakers.

Providers on denied claims: ‘We’ll fight to the end’

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09/12/2014

YARMOUTH, Maine – A defiant 60% of the respondents to last week’s HME NewsPoll say they wouldn’t take up CMS on an offer to settle pending appeals in exchange for partial payment.

In brief: CMS responds to AAH, complex rehab bill adds sponsors

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09/12/2014

WASHINGTON – Contractors conducting pre-pay audits and prior authorizations are required to load that information into the RAC Data Warehouse, CMS has said in response to an AAHomecare inquiry.

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