Reimbursement


NGS: Proper Info Needed for Redeterminations

NGS reminds providers what information is needed for redetermination requests.

Medicare Contractors to Attend Medtrade

Attendees to include reps from four DME MACS, NSC, CEDI and CBIC.

Providers Reminded of Beneficiary Authentication Info When Using IVR

Information is needed regardless of type of inquiry.

CMS Requests More Info on Proposed California Medicaid Cuts

On Sept. 28 deadline, CMS asks for additional data on how beneficiaries' access would be impacted.

HHS Releases Final Rule for Medicaid Audit Program

New RAC program, to start Jan. 1, is modeled on controversial Medicare program.

Ops Management

Overcoming the Challenges of Adapting to Increasingly Lower Reimbursement

The reality of doing business in our industry in 2011 is that it is no longer enough to run a competent company that works hard to do a good job for patients.

NCART Medicaid Summit Planned for November

St. Louis event to help providers share best practices, strategies and updates.

Jurisdiction B to Continue K0823 Prepayment Reviews

Denial rate for Group 2 standard power chairs in quarter two was 77 percent for examined claims, National Government Services says.

NHIC Reports K0823 Review Findings

Prepayment reviews for Group 2 standard power chairs are scheduled to continue based on 2011 quarter-two denial results.

Future Audit Demand Letters to Come from MACs

Starting Jan. 3, recovery auditors will alert MACs about claim adjustments needed.



CMS 5010 Testing Week Scheduled for Aug. 22-26

Implementation date for 5010 usage, which is tied to new ICD-10 codes, is Jan. 1, 2012.

CMS Issues Reminder of New ABN Form

New form must be using starting Nov. 1.

DME MACs Instructed to Deactivate Accreditation Edit

Claims should no longer deny due to accreditation error.

Funding Essentials

Coverage Criteria: CMS Clarifies PMD "Rules of the Road"

NGS Analysis Shows Incorrect GA Modifier Usage

Modifier concerns regard claims for pressure-reducing support surfaces.

Calif. Medical Association Files Brief to Protest Medicaid Cuts

Physicians' organization says state hasn't considered the impact of cuts on beneficiaries' access to care.

Texas Providers Protest Proposed Medicaid Cuts

Additional DME reimbursement cuts would range from 6 to 26 percent.

Funding Essentials

Whac-A-Mole, Anyone? Medicare & Medicaid Challenges

CMS: Still No PECOS Implementation Date

Reminder bulletin says ordering/referring provider claim edits still not being applied.

CMS Updates Power Chair Rental FAQs

Question topics include breaks in service and repair/replacement policy.

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