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MACs join forces to reduce denials

07/30/2013HME News StaffWASHINGTON – The Part A and Part B Medicare Administrative Contractors have formed a task force to educate on national issues of concern regarding improper payment errors, they...

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No stop to prepay review for certain power wheelchairs

08/05/2013HME News StaffINDIANAPOLIS – National Government Services (NGS), the DME MAC for Jurisdiction B, has reported a claims error rate for power wheelchair bases with options and accessories of...

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What’s behind PMD demo denials?

11/05/2013HME News StaffINDIANAPOLIS – Prior authorization requests submitted as part of the PMD demo are being denied because of conflicting information in face-to-face examinations and other medical...

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Obscure court ruling could set powerful precedent

12/13/2013Elizabeth DepreyWASHINGTON – A 5th Circuit Court ruling over runny eggs could be just the ammunition HME providers need in cases involving ambiguous CMS guidelines.“People think this case is...

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Audits: ‘We are in crisis,’ stakeholders say

02/14/2014Theresa FlahertyWASHINGTON – HME stakeholders made their case against an audit program run amok at a forum last week.“We need to have a resolution on how to help my providers today because we...

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QIC overturns denials

04/18/2014HME News StaffWATERLOO, Iowa – Seventy-percent of the denials that U.S. Rehab’s Peggy Walker sent to C2C Solutions for review following a forum hosted by the Office of Medicare Hearings and...

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In brief: CMS awards new bid contracts, QIC overturns denials

04/18/2014HME News StaffHONOLULU – CMS has awarded new competitive bidding contracts to two local providers in Hawaii: Aloha Medical and American Home Care Systems. To date, just 13 of the 97 providers...

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NewsPoll: Providers receive some far-out denials

01/16/2015Tracy OrzelYARMOUTH, Maine – Imagine having a claim denied because Medicare doesn’t like the handwriting on the prescription.That was the case for one provider who responded to a recent HME...

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Medicare sees a number, not someone’s mother

01/30/2015I need to call a patient's family and tell them that I either have to pick up the hospital bed they are renting from me, or they have to sign a document that states they are willing to pay...

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Swear words, celebrities and everyday people

Liz Beaulieu03/19/2015It’s not uncommon for me to be at a loss for blog ideas.That’s certainly the case this week, especially after Managing Editor Theresa used WTF in her blog (yes, I noticed) and...

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Demo allows providers to make their case by phone

03/08/2016HME News StaffJACKSONVILLE, Fla. – C2C Innovative Solutions, the Qualified Independent Contractor or QIC for the second level of Medicare appeals, is conducting a demonstration project that...

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MACs ease denial process for oxygen claims

05/11/2018HME News StaffWASHINGTON – The DME MACs are adding modifiers that will allow HME providers to provide additional information related to the coverage and/or liability when the policy criteria...

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