Tag: Billing
Billing: Protect PHI
October 16, 2024Kit Shellhouse
Q. What types of information will I be required to provide to the OCR in the event of an audit of my HIPAA compliance program?
A. Being proactive will alleviate the pressure of an OCR (HSS Office for Civil Rights) audit. The OCR will request documentation from you as a provider. This information must demonstrate that your company has adhered to the required HIPAA Program.
To prove adherence, a portion of the required documentation will include the policies and procedures related...
CMS issues final rule on catheter billing
September 26, 2024HME News Staff
WASHINGTON – CMS has issued a final rule that addresses suspicious billing activity within the Medicare Shared Savings Program that resulted in an increase in DMEPOS billing for certain intermittent urinary catheter supplies. The rule, “Medicare Program: Mitigating the Impact of Significant, Anomalous, and Highly Suspect Billing Activity on Medicare Shared Savings Program Financial Calculations in Calendar Year 2023” (CMS-1799-F) is part of a larger strategy to address significant,...
Noridian responds to orthotics inquiries
September 23, 2024HME News Staff
WASHINGTON – Noridian Healthcare Solutions has published an update for billing custom-fitted orthotics when no custom fitting is completed with no off-the-shelf equivalent available. “Due to recent inquiries from suppliers, it has come to our attention that some miscellaneous codes used for billing off-the-shelf orthotics, when a custom fit orthotic is provided but no custom fitting is performed, may require specific policy and laterality modifiers,” it states. These claims must...
Poll respondents work to lower costs, increase sales
September 20, 2024Theresa Flaherty, Managing Editor
YARMOUTH, Maine – With reimbursement strained, it’s unsurprising that 50% of respondents to a recent HME Newspoll say they’ve targeted billing/collections as an area for improvement this year.
One way they’re doing that: Gaining efficiency through new billing software, but it’s a process that takes time, say respondents.
“We needed to reduce overhead expenses by reducing manual tasks,” wrote one respondent. “(I) didn’t expect...
Billing: Maintain clean record
September 16, 2024Kit Shellhouse
Q. Should I be performing regular audits of my provider enrollment record?
A. Short answer, yes! Providers should review, or audit, their Provider Enrollment Record at least annually. In doing so, you could avoid potential issues with incorrect or outdated information that, when discovered by your payer’s provider enrollment department, could result in a revoked or deactivated enrollment. Loss of enrollment status could not only result in penalties and fines, but also impede the ability...
RedSail partners with NikoHealth
September 10, 2024HME News Staff
MIDDLETOWN TOWNSHIP, N.J. – RedSail Technologies has announced a partnership with NikoHealth to elevate its service offerings for its HME pharmacy customers. As part of the partnership, RedSail’s customers will be introduced to the HME-focused features of the NikoHealth platform. “For customers seeking a more HME-focused system, NikoHealth emerged as the preferred choice due to its next-generation, cloud-based HME system, which offers robust features that have garnered excellent...
New survey: Denials tops list of challenges
July 16, 2024HME News Staff
CHARLOTTE – The No. 1 billing and revenue cycle management challenge for HME providers is preventing or reducing denials and appeals, according to the results of a new survey sponsored by Prochant and conducted by in90.
The No. 2 challenge: Hiring, training and retaining qualified intake, billing and collections staff.
“In response to these challenges, 60% of respondents have outsourced at least one RCM function in the past year, with over 70% attributing this decision...
‘Switching heads’ syndrome: CPCG wants more, not less, fragmentation
May 29, 2024Liz Beaulieu, Editor
WASHINGTON – Saleem Shah officially debuted Collaborative Patient Care Group (CPCG) at Medtrade in March after developing business-to-business offshoring and custom technology development solutions for his own company, New Hampshire Medical Supply, in 2019 and offering them to other companies starting in 2023.
CPCG’s “belief system”: To take over certain tasks so HME providers can eliminate the “switching heads” syndrome that holds them back from peak...
NikoHealth names account success manager
March 12, 2024HME News Staff
MIDDLETOWN TOWNSHIP, N.J. - NikoHealth has named Dana Cline, CDME, a seasoned professional with more than 20 years of experience in the HME industry, as an account success manager. Cline’s career spans a broad range of roles, including 12 years in operations and eight years in health plans, as well as significant contributions to large corporations, local companies and hospital-owned DME providers. Her expertise spans intake, resupply, sales, accreditation, inventory and operations, complemented...
Change Healthcare outage has ‘scary’ impact on HME industry
March 6, 2024Liz Beaulieu, Editor
YARMOUTH, Maine – The cyberattack that hit Change Healthcare in late February is making it difficult for HME software companies and their provider customers to process and bill claims, creating a dent in cash flows.
Change Healthcare, which processes 15 billion transactions annually, detected the cyberattack on Feb. 21 by a threat actor named “ALPHV/Blackcat,” forcing it to disconnect its systems.
“I’ve been in this industry for 25 years and I’ve...