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We aren’t the first to report headlines. We write articles that help DME billing teams use reimbursement evolution to their advantage.

Noridian Error Incorrectly Rejects Certain CGM Claims

A while back, DME MAC Noridian Healthcare Solutions, Inc. incorrectly rejected certain continuous glucose monitor (CGM) claims billed to Medicare Jurisdictions A and D between January 4 and January 19, 2023. The processing error rejected items billed with the old...

What DME MACs Say About Post-PHE Claims

On April 28, 2023, the DME MACs published claim instructions related to CR modifier and COVID-19 narrative usage after the public health emergency (PHE) ends on May 11, 2023. The bulletin counters CMS’s previous guidance to discontinue the pandemic-era claim elements...

Simple Recoupments May Cause Medicare Revocation

Did you know that a recoupment for a single patient can trigger the revocation of a DME supplier’s Medicare number? I am seeing more suppliers suffering terrible consequences from simple oversights, and I don’t want it to happen to you. Here is...

Do this Before Chasing an Old Sleep Study

Here is a question I get all the time: I have a new patient eligible for a five-year CPAP replacement, but we are having a hard time getting a copy of the patient’s original sleep study. Medicare paid a different supplier for the initial equipment. Do we have to send...

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