Tag: Sylvia Toscano
ACU-Serve zeroes in on strategy
November 5, 2021Liz Beaulieu, Editor
AKRON, Ohio – ACU-Serve’s recent acquisition of Professional Medical Administrators better positions the company to “help grow and support” smaller HME providers amid another wave of consolidation in the HME industry, says CEO Jim Knight.
Knight says ACU-Serve has lost “some of our bigger customers” due to consolidation, including Aerocare, which was acquired by AdaptHealth, and now, with Pro-Med, it is better positioned to offer leading-edge technology,...
Stakeholders pound pavement in Florida
March 30, 2020Liz Beaulieu, Editor
TALAHASSEE, Fla. - The state of managed care in Florida motivated Sylvia Toscano, a long-time industry consultant, to visit the state capitol for the first time in January.“To see these unhealthy patterns happening with MCOs and TPAs in the state has been upsetting,” said Toscano, who was part of a group of more than a dozen members of the Florida Alliance of Home Care Services (FAHCS) to make the trip. “I'm seeing small providers just shutting down because of it. That's what got...
Auditors avoid appeals process, make 'major' requests
November 27, 2019Liz Beaulieu, Editor
YARMOUTH, Maine - If you're an HME provider trying to appeal a denial by a managed care payer, it's probably not going very smoothly, reports consultant Wayne van Halem.“There's a process for appeals they have to follow that's outlined in the managed care manual and they're not doing that,” said van Halem, president of the van Halem Group.The process is similar to Medicare's: a number of levels of appeals, including redetermination, reconsideration and administrative law judge or ALJ.Instead...
Notes from the field: diversification and billing
March 21, 2018Liz Beaulieu, Editor
Medicare: Take it or leave itProvider Roger Lichty has slowly transformed his business over the past few years so that vehicle mobility is now his No. 1 business.Under the product category, Mobility Connection in Rockford, Ill., offers everything from wheelchair accessible vans to vehicle lifts to driving controls. The emphasis: cash.“It's actually what's keeping us profitable at the moment,” said Lichty, owner.Mobility Connection also provides personal mobility and home access products...
Providers resist EHR bandwagon
October 22, 2015Tracy Orzel
YARMOUTH, Maine - While there's a rush toward EHRs, some HME providers are holding fast to their paper-based systems.
Provider Angel Pardo, owner of DMR in Doral, Fla. recently purchased a $10,000 filing system to help maintain 31 years worth of records.
“I always like to have a paper copy,” said Pardo. “You hear about servers crashing, data corrupting. God forbid you need something and the data is lost.”
His No. 2 concern: security.
“With paper records,...
Reporter's notebook: Crash course in charting and other calamities
September 26, 2014Liz Beaulieu, Editor
For years, HME providers have been trying to teach physicians what they need to include in their chart notes, often to no avail, says Sarah Hanna, president of ECS Billing & Consulting North.But the transition to ICD-10 may be the thing that finally gets through to them, she says.“How a physician gets paid corresponds to a diagnosis procedure code,” she said. “Well guess what, to prove medical necessity for an ICD-10 code, which is more specific, you have to chart in a way that...
Collecting at any cost
June 13, 2014Theresa Flaherty, Managing Editor
YARMOUTH, Maine - When provider Tammy Zelenko gets ready to close the books on her fiscal year every June, she strives to close out outstanding patient balances.
Sometimes, that means offering a discount to patients to get them to pay up.
“You'll do whatever it takes to get that money,” said Zelenko, CEO of AdvaCare Home Services in Bridgeville, Pa. “It's better than ending up writing it off or sending them to collections.”
With more patients paying out of...
Medicare permits walker upgrades
March 28, 2014Letter to the Editor
Persistence paid off in this case. Below is the final determination from Medicare since the initial HME News article (“Unbundling trips up providers,” December 2013).The DME Medical Directors have decided that hand brakes are different from glide-type brakes and can be billed at initial issue for some walkers (i.e., E0143 is the most common HCPCS code billed) per the related Policy Article for Walkers. Use A9270 when billing hand brakes and other enhancement...
Providers avoid shortened timeframe
December 20, 2013Liz Beaulieu, Editor
WASHINGTON - It looks like the timeframe for responding to initial documentation requests as part of the Comprehensive Error Rate Testing (CERT) program will stand at 75 days.
CMS had planned to shorten the timeframe to 60 days, but Kim Brummett, senior director of regulatory affairs for AAHomecare, confirmed last week that the agency has tabled its plans indefinitely.
“I received word from the CERT coordinator that the change in the timeframe has been placed on hold until further notice,”...
Different take on unbundling
December 20, 2013Letter to the Editor
In response to your story “Unbundling trips up providers” (HME News, December 2013), I would like to draw your attention to the following clarification from the Jurisdiction B DME MAC:“Hand operated brakes are considered an enhancement (with the exception of those described in code HCPCS E0147). An enhancement accessory is one which does not contribute significantly to the therapeutic function of the walker. Suppliers are to bill HCPCS code A9270 when an enhancement accessory for...