In brief: New CPAP provider launches, contractor clarifies bed billing

Thursday, August 4, 2011

RALEIGH, N.C. – Vince Cole and Patrick O'Brien have launched Activa Medical, an online provider of CPAP machines, supplies and accessories, as well as home sleep testing. Both former HME owners, Cole and O'Brien stated in a press release that they plan to offer a broad selection of equipment at 50% to 75% less than a traditional HME provider. Activa Medicals launch is a cultivation of passion for its customers, the desire to provide superior patient care as well as a byproduct of changes in the national healthcare legislation, stated Vince Cole.

Therapeutic shoes have whopping denial rate

WASHINGTON – National Government Services, the Jurisdiction B DME MAC, is continuing its prepayment review for therapeutic shoes. Of 246 claims reviewed by June 30, 2011, 229 (93%) were denied. The top two reasons were no documentation received (53%) and denied as non-covered (31%). The top reasons contributing to those denials are not responding to the request for documentation letter within 30 days; and insufficient or no medical records from the physician.

Contractor clarifies billing for beds

WASHINGTON – National Government Services, the Jurisdiction B DME MAC, stated in a message last week that it has seen an increase in billing issues for hospital beds with mattresses, hospital beds without mattresses and support surfaces. As a result, the contractor has developed several articles to clarify billing on these items. Key points addressed in the articles include: granting of new capped rental periods for hospital beds, air flotation beds and air-fluidized beds; correct coding for hospital beds with mattresses, group I support mattresses, and group II support mattresses; upgrade billing; use of the KX, GA, and GZ modifiers; and correct billing to avoid the appeals process.

Invacare, providers named in lawsuits

ELYRIA, Ohio – Invacare was named in two lawsuits last month. Invacare and Apria have been named in a lawsuit brought by Carolyn Davidson of LaPlace, La., who claims the brakes on her walker failed, causing her to fall. Invacare and The Scooter Store have been named in a lawsuit brought by Candess Higgerson of St. Clair County, Mich., whose father died in June after he and his power wheelchair were hit by a car. Higgerson claims the wheelchair was defective because it was not equipped with flags or other devices to make it visible to motorists.

Short take: Acu-Serve

Acu-Serve has introduced a new tool, the Acu-Dashboard, that allows users to measure key performance indicators against industry benchmarks and identify issues affecting their cash flow.