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The van Halem Group

Medicaid: Expect more scrutiny

Several factors are contributing to an uptick in audits, say consultants
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04/12/2019

YARMOUTH, Maine – With the Office of Inspector General and other government agencies regularly issuing reports on Medicaid overpayment issues, it’s no surprise that audits are increasing, says Kelly Grahovac.

TPE program: Still a work in progress

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01/11/2019

WASHINGTON – CMS has updated its “Targeted Probe and Educate” program in two ways that could potentially make it easier and more fair for HME providers.

Patients Over Paperwork: Room for improvement for HME

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10/05/2018

WASHINGTON – Much has been made of CMS’s plans to reduce the paperwork burden for healthcare providers, but what about for HME providers, specifically?

Don’t gamble on your claims, van Halem Group says

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04/23/2018

LAS VEGAS – Although Medicare is attempting to reduce claim denials and appeals with a “friendlier” process, HME providers still need to take that process seriously.

Industry appeals for ‘common sense’

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02/02/2018

WASHINGTON – HME issues took center stage at the inaugural meeting of a new CMS focus group aimed at putting “Patients Over Paperwork.”

Vents: RACs join the party

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01/26/2018

WASHINGTON – The national recovery audit contractor for HME has set its sights on ventilators, but that’s no big surprise, industry stakeholders say.

van Halem Group gets HIPAAwise

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08/23/2017

ATLANTA – The van Halem Group, a division of The VGM Group, has finalized an agreement with HIPAAwise to exclusively offer its online HIPAA Compliance Program application to healthcare providers in the post-acute care market.

Improvements to the Adjudication Process of Serial Claims

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06/26/2017

A major win for DME suppliers was announced recently, as CMS released information regarding improvements to the adjudication process of serial claims.

Are you RAC ready?

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04/24/2017

Since it’s been so long since HME providers have had to grapple with a RAC, stakeholders offered these pieces of advice:

Audits: Use two-tier approach

Q. We received our audit results, which include a large amount of money owed to Medicare based on an extrapolated overpayment! What do we do now?
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04/20/2016

A. To reduce or remove the extrapolation, you will need to appeal the overpayment determination, addressing both the individual claims reviewed in the audit and the extrapolation itself. Consider this a two-tier appeal process.

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