Tag: van Halem Group
Billing: Manage your risk
December 10, 2024Kit Shellhouse
Q. How can I stay compliant with Medicare’s fee-for-service plans?
A. Dealing with Medicare fee-for-service plans can be tricky, but there are ways to manage the risks and stay compliant. Documentation errors are a primary risk, as Medicare is extremely strict, and any mistakes can lead to claim denials or audits. To avoid these risks, ensure all patient records, prescriptions and proof of delivery are thoroughly documented and easily accessible. Billing inaccuracies, such as incorrect...
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...
William Felix on recognizing innovation, while protecting Medicare
October 18, 2024Theresa Flaherty, Managing Editor
YARMOUTH, Maine – Dr. William Felix has worn many hats throughout his career, including chief medical officer for Medicare DMEPOS and medical director of the Pricing, Data Analysis and Coding division at Palmetto GBA, but one constant is his passion for getting innovative technology into the hands of patients.
“The sooner the patient or the beneficiary can have their hands on this technology that can improve their quality of life, along with a healthy lifestyle, and their lives...
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...
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...
van Halem Group adds two consultants
August 20, 2024HME News Staff
ATLANTA – The van Halem Group has added Dr. William Felix and Melissa Pederson, RN, to its team of consultants. “We are thrilled to welcome Melissa and Will to our team,” said Wayne van Halem, president, The van Halem Group. “Their background, skills and expertise are perfectly aligned with the services we provide to our clients, and we are lucky to have them.”
Felix previously served as the medical director of policy at Cohere Health. His extensive...
Kit Shellhouse rejoins OAMES board
May 9, 2023HME News Staff
ATLANTA – The van Halem Group has announced that Kit Shellhouse, director of business development, has been named as an associate board member of the Ohio Association of Medical Equipment Services (OAMES). “Serving as an associate board member for OAMES is a privilege,” Shellhouse said. “To fight for our patients, state associations must continue to play a vital role in the business. Supporting providers from a local level to Capitol Hill on a state and national level is essential.”...
Kit Shellhouse joins van Halem Group
March 27, 2023HME News Staff
ATLANTA – Kit Shellhouse, formerly of ECS North and ACU-Serve, has joined the van Halem Group, a division of VGM Group, as director of business development. Her duties will include managing key partnerships, generating new clientele, fostering relationships and building the van Halem Group brand. “I have known and worked with Kit for over 15 years,” said Wayne van Halem, president of the van Halem Group. “She is a widely recognized thought leader in our industry, and I am...
ALJ backlog: Providers will have ‘fighting chance’ again
February 18, 2022Liz Beaulieu, Editor
ATLANTA – The Office of Medicare Hearings and Appeals should be caught up on a years-long backlog of appeals at the administrative law judge (ALJ) level sometime this summer, predicts Wayne van Halem, president of the van Halem Group.
That means OMHA should be back to holding hearings at the ALJ level within 90 days as required by law, he says.
“The appeals process has to be timely,” he said. “If the appeals process is timely and Medicare has to hold off...
van Halem Group adds thought-leader
July 27, 2021HME News Staff
ATLANTA – The van Halem Group has announced that Dr. Doran Edwards has joined its team as a medical advisor. Edwards recently retired after three years with Palmetto GBA, where he was the medical director for the Pricing, Data Analysis and Coding contractor. He was also the medical director of the SADMERC, the predecessor to the PDAC from 2003-08. “Over the last few years, the van Halem Group has been working with manufacturers as they bring new products to market and need to navigate...