Tag: Compliance
Billing: Invest in compliance
November 13, 2024Kit Shellhouse
Q. What steps can I take to prepare for audits under managed care contracts?
By Kit Shellhouse
A. As a provider, preparing for audits under managed care contracts can be a chore, but the key is to understand the requirements and expectations well in advance. Invest time in reviewing your managed care contracts to grasp all requirements, including billing procedures, documentation standards and compliance obligations. This foundational knowledge is crucial for staying well-informed...
Accreditation/Compliance: Know these seven elements
August 5, 2024Mary Ellen Conway
Q. I am new to DME compliance. Where should I get started?
A. The first place you should start is to make sure your company follows the federally mandated Seven Element Compliance Plan.
1. Implement written policies, procedures and standards of conduct. Most likely your company has effective policies and procedures in place, along with clearly stated standards of conduct in your employee handbook. Review them all to ensure that they are clear and concise.
2. Designate a compliance officer...
VGM offers outsourced clinical service
August 15, 2023HME News Staff
WATERLOO, Iowa – VGM & Associates has officially launched Sleep Services, a CPAP setup and compliance program that aims to create relationships with patients for ongoing care and success, the company says. The program comprises no-touch delivery, onboarding, patient setup, compliance and post-compliance monitoring. “This program helps our members with staffing, revenue and patient compliance,” the company says. “By using Sleep Services as their outsourced clinical service,...
Legal: Tailor your compliance program
January 16, 2023Michael Silverman
Q. As we dive into 2023, what steps can my Medicare-enrolled HME business take to aid in regulatory compliance?
A. While most HME businesses are aware of the “low hanging fruit” of ongoing regulatory compliance obligations – such as timely updating Medicare enrollment applications (855S), checking employees/contractors against federal exclusion lists, and staying updated on licensure requirements – many do not have written policies and procedures in place detailing how...
CPAP therapy has become less efficient
April 8, 2022Theresa Flaherty, Managing Editor
YARMOUTH, Maine – With HME providers struggling to obtain CPAP devices, payers should consider suspending compliance requirements, they argue.
Current Medicare guidelines call for patients to use their CPAP machines for at least four hours per night at least 70% of the time within any given time frame.
“It’d be great if they did, but I don’t have much hope any payer is going to,” said Woody O’Neal, vice president of Pelham, Ala.-based O2 Neal...
Medical Service Company creates pathway to compliance
November 23, 2021Theresa Flaherty, Managing Editor
ATLANTA – With 70% of patient outreach calls going to “voice mail hell,” Medical Service Company knew it needed to revamp its PAP adherence program to boost patient engagement and compliance, and create better efficiencies.
So, the company set out to create an automated, scalable program using not only voice calls but also texts and emails, based on preference, to assess patients and evaluate factors that affect outcomes.
“So much of our process was to ask...
Össur program meets privacy requirement
November 9, 2021HME News Staff
FOOTHILL RANCH, Calif. – Össur has announced that its Empower By Össur program has earned renewed certified status for information security by HITRUST. HITRUST CSF Certified status means that Empower by Össur has met key regulations and industry defined requirements, and that it is appropriately managing risk. “Organizations and programs like Empower by Össur are under more pressure than ever to meet complex compliance and privacy requirements that include technical...
Resupply: Measure it to manage it
December 14, 2020Mark Boardman
Q. How well is my CPAP compliance and resupply program performing compared to other HME providers?
A. Perhaps one of the more useful statements pertaining to business excellence is, "If it can't be measured, it can't be managed." Applying this to key aspects of our businesses is critical if growth and improvement objectives are going to be achieved. If a business goal or objective is to become a leader in CPAP compliance and resupply, it is essential to know the industry benchmarks to...
Providers on mask tools: They're 'tremendously valuable'
June 26, 2020Theresa Flaherty, Managing Editor
YARMOUTH, Maine - New tools aim to reduce the guesswork when it comes to helping sleep apnea patients get the right masks and maintain compliance, say CPAP providers.ResMed in May launched ResMed MaskSelector to create personalized mask recommendations based on a patient's sleep attributes and facial measurements; Philips Respironics last year launched Philips Mask Selector to leverage 3D technology to find the best mask fit.“(These tools are) tremendously valuable,” says Brad Heath,...
Large number of vets not receiving follow-up care for their sleep apnea, OIG says
January 29, 2020HME News Staff
WASHINGTON - The Veterans Health Administration is at risk of potentially spending $261.3 million over the next five years on sleep apnea devices and supplies that veterans will not use, according to the Office of Inspector General.Nearly half of the almost 114,000 veterans who were not consistently using their devices did not receive the necessary follow-up care, the OIG found.“Sleep medicine clinicians at VA medical facilities told the audit team they were unable to use available usage data...