Reimbursement

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Friday, January 31, 2003

Are you ready for an audit?
With Jeanie Lane

Q: With the DMERCs becoming increasingly aggressive in their auditing efforts, is there anything a company can do to avoid an audit?
A. At the present time, I’m not sure there is a way to avoid audits. In fact, CMS has advised the DMERCs to increase audits in full force. There are some things you can do, however, that will help deflect attention from your company, whether it be from the DMERCs, OIG or FBI. It no longer is a matter of “Will I be audited?” but when. You and your employees should be prepared, not surprised.

First of all,I recommend you have the supplier standards typed on your letterhead and displayed in the front area of each location. All employees should be aware of the supplier standards.

Secondly, if you do not have it in writing, you do not have anything.

Your patient files should include at minimum the following documents:

- Delivery ticket, including description of item delivered, quantity, and signature showing proof of delivery, serial number and manufacturer.

- Signature agreement specific to item. This must be signed by the patient or authorized representative.

- Original order or CMN completed, signed and dated by the physician.

- Advanced Beneficiary Notice (ABN).

- Waiver of coinsurance (financial hardship, if applicable).

- Any exchanges, repairs or pick-up tickets.

- Patient complaints and resolutions.

- Rental/purchase option letter for capped rental items and/or power wheelchairs purchased in the first month.

Jeanie Lane is an independent consultant with The MED Group. Reach her at 601-372-5191.

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