The RAC is well known for audits and recovery of overpayments (they taketh away). But, does the RAC ever giveth? As far back as I can remember, I’ve never heard of any Medicare contractor reviewing claims for UNDERPAYMENTS then giving money, which is due, back to the providers. You may not be aware of this,
You know the old slogan, “Do you want the good news first or the bad news?” Well, we are optimistic so we will give you the good news first. Good News – Mass Adjustments Starting in May not July! They are starting two months earlier than expected, AND providers do not have to take any
This is a heads up to those who provide custom cushions (E2609) and backs (E2617) to Medicare beneficiaries! The Jurisdiction B and C DME MAC has decided to develop set fees for these custom items and did this internally without notice to the provider community. As of today DME A and D has NOT implemented this change.
CMS has announced that prior authorization (PA) for power wheelchair codes K0856 (Group 3 single power option) and K0861 (Group 3 multiple power option) will begin in March in New York, Illinois, Missouri and West Virginia. It is expected to go nationwide in July. PA requests from New York, Illinois, Missouri and West Virginia will
The National Supplier Clearinghouse (NSC) is required to revalidate DMEPOS suppliers every three years. When it is time for a supplier to revalidate, the NSC will send a letter with steps to follow and a bill for the $560 fee. Step #1: Complete the CMS 855S application form One of the steps toward revalidation
With the end of the year approaching fast, now is the time to decide if you will be a participating (par) or non-participating provider. Before making your decision, we highly encourage you to watch this video, read the article below and download these slides from reimbursement experts Ronda Buhrmester and Dan Fedor. Unlike golf, being
At the Medtrade Spring Jurisdiction D council meeting, C2C Innovation Solutions shared updates with the supplier community. Currently there is a demonstration project that consists of two phases in Jurisdiction C and D only for diabetic testing strips and oxygen equipment. The first phase has allowed suppliers the opportunity to participate in a formal recorded
Non-Invasive ventilators (NIV) have been circling back with questions on documentation requirements. This means it’s time to review the requirements needed for NIV coverage particularly since there is not a medical policy (LCD). Here are helpful tips regarding ventilator coverage: Generally covered for treatment of neuromuscular disorders, thoracic restrictive diseases, or chronic respiratory failure secondary
We are anxiously waiting to hear the status of the amended HR 5210 with the three-month delay. Yesterday we were told it was picked up by unanimous consent by Senate Republicans. The Senate Democrats were late to pick up on the bill last night, but we should hear more later today. Time is ticking though!
After the extension of time allowed for companies to accept their Round 2 Recompete bids, today is the final day to do so. As in previous competitions, there will likely be an additional round of contract offers in many CBAs. To be clear, those suppliers with current offers in Connexion must complete the response by