Letter to the editor: There must be a better way
How long do these people have to do an audit and hold up our cash flow? Are there any rules to this game?
They are doing it to us and a bunch of others, including doctors, home health, DME and O&P. If they conduct too many audits at once and have no timeline to have the claims audited, that could double, triple or quadruple the time it takes to get paid! It will affect my payroll for the week after next and further, as we are holding billing for two weeks so they cannot audit what is not sent. But this can create the same problem again after that! Not to mention paying vendors.
There must be a better way to handle this.
Shouldn't the DME MACs be required to follow the law and dispense funds as dictated by Medicare?
They also add further insult by stating at the bottom of the request "this claim pulled for atypical billing practices or patterns." For a cane? TENS supplies for a patient-owned TENS? A back brace for a herniated disc fit by a licensed orthotist? Please!