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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.
New ABN Form Complaint Language Could Confuse Beneficiaries
The Office of Management and Budget (OMB) recently updated the Advance Beneficiary Notice of Noncoverage form … you know it as the ABN. While there are no dramatic modifications, suppliers should use the new version for all ABNs executed on or after July 1, 2023. CMS...
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...
Get Ready for Surge of Medicaid Patients Losing Insurance
Continuous Medicaid enrollment established under the Families First Coronavirus Response Act (FFCRA) ended on March 31, 2023. I am sure I am not the first to tell you about the millions of Medicaid beneficiaries that will lose coverage in the coming months....
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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