Tag: Regency Billing and Consulting
Accreditation: Plan carefully to avoid pitfalls
January 24, 2019Kelly Wolfe
A. 2019 is a big year for the HME industry when it comes to accreditation renewals and adding product categories to your line of business. Many providers are considering adding new lines of business since the lifting of competitive bidding until January of 2021. Please make sure and be aware that any item you decide to provide needs to be updated with not only your accrediting body but the National Supplier Clearinghouse as well. If you are in a state that has licensure, you may need to do...
New audit program makes concessions
August 25, 2017Liz Beaulieu, Editor
WASHINGTON - HME stakeholders and billing consultants are “cautiously optimistic” about a new program aimed at streamlining the number of audits.CMS announced Aug. 14 that the Medicare Administrative Contractors will soon start focusing their reviews on providers that have the highest claim error rates or irregular billing practices, eliminating the burden on providers who are already submitting claims that are compliant.“We're cautiously optimistic, but it's something we'll be...
Take PECOS seriously, stakeholders say
November 8, 2013Liz Beaulieu, Editor
WASHINGTON - CMS has set a new start date for denying DME claims with the names of physicians who are not enrolled in PECOS and, this time, it may stick, industry stakeholders say.
Starting on Jan. 6, 2014, claims with the names of physicians who are not enrolled in PECOS will be denied, and the provider who submitted the claims will not be paid for the items or services that were furnished. Most recently, CMS had planned to start denying claims on May 1, 2013.
“It feels real this time,”...
Prosthetists criticize proposed template
May 31, 2013Theresa Flaherty, Managing Editor
BALTIMORE - A proposed clinical template for lower limb prostheses overlooks the way care is delivered, say industry stakeholders.
“They still don't seem to want to allow the prosthetists to have as much input as they probably should have in terms of documenting medical necessity,” said Ryan Ball, director of state policy for VGM & Associates.
CMS has posted a draft of the template on its website. The template features a series of prompts that would help physicians understand...
Deal opens door to more audits
January 11, 2013Elizabeth Deprey
WASHINGTON - Tucked into the “fiscal cliff” deal is a provision that could mean bad things for providers already inundated with audits: the extension of the look-back period.Effective Jan. 2, the date the president signed the bill into law, CMS contractors can audit claims going back five years instead of three years.“Even the best providers, the ones who do the best paperwork, are more likely to have issues with those older claims,” said Kelly Wolfe, CEO of Regency Billing...