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      Reimbursement
      Providing oxygen after the 36-month cap

      Q. How can I avoid getting denials from Medicare for same or similar equipment? I'm especially concerned now that oxygen caps at 36 months.

      A. Same or similar denials occur quite frequently among providers. This may seem like a difficult denial to avoid. However, with diligent up-front processes, you can protect your cash flow.

      The first step is to ask the patient if he has ever had the equipment before or something similar. Be sure to gather information on what equipment he had, when and where he got it, if it was returned, and why he needed this equipment if he had same or similar equipment in the past. You may also contact Medicare for information. Each MAC handles this a little differently, some offering more options than in the past. For example, Region B offers an automated way to determine what CMNs are in the common working file. This allows you to find out the original oxygen start date and, as a bonus, the recertification date.

      So what do you do with this information? In the case of oxygen, keep in mind that the clock started ticking for the cap on Jan. 1, 2006. Therefore, before taking on a switch-out patient, you want to make sure you are not going to lose money. To do this, calculate what your total reimbursement is going to be based on the time remaining in the cap.

      Once you know a patient had same or similar equipment, use the advanced beneficiary notice. This allows you to alert the patient that he may be financially responsible. You may also collect the money up front and file the claim non-assigned. If the patient has had a change in condition or if there has been a break in service of at least 60 days, include something brief in the narrative field of the claim to avoid a denial. Lost, stolen, broken and obsolete equipment replacements may also be paid with supporting documentation. hme

      Lisa Bargmann is president of Bargmann Management LLC and Homecare Collection Service. Reach her at 440-225-8299 or lbargmann@homecarecollection.com.

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      HME News Info Center
      SOURCE BOOKS
      2010 Technology Special Report
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      Market takes a pounding p.3... Be upfront p.5...
      HME 2008 State of the Industry
      HME Sleep special report
      CALENDAR

      September 2010
      September 2, 2010 @ 2:00pm EST
      This webinar will set out to distinguish the difference between Medicare myths and reality. Participants will learn what is really acceptable under Medicare guidelines and will have the opportunity to get their own Medicare myths debunked.
      Cost is $99. Register at: http://www.miravistallc.com/recent_services.php

      2:30-4:00 p.m. ET
      Don’t miss the “Pre-Payment Reviews and RAC Audits: Steps to Prepare for and Survive These Life-Altering Events” teleconference on Thursday, September 9, 2010 from 2:30- 4:00 p.m. ET, with Jeffrey Baird, Esq., Brown & Fortunato.
      To participate in the September 9 teleconference, complete the form and return the member registration fee of $129/non-member registration fee $189, per phone line by Wednesday, September 8, to Ashley Wyatt, AAHomecare, 2011 Crystal Drive,  Suite 725, Arlington, VA 22202, 703-535-1880 or fax to 703-836-6730. You will receive instructions on connecting to the call as well as any handouts or additional information by e-mail. Please submit questions in advance to ashleyw@aahomecare.org no later than September 8. No refunds after September 8.

      AAHomecare teleconference. 2-3:30 p.m. ET. FMI: 703-535-1880

      San Diego, Calif.
      Anyone applying for an exemptee license through the Department of Health Services and is responsible for overseeing prescription devices should be sure to attend this seminar. After this training program, attendees will be knowledgeable of the U.S. Pharmacopoeia standards that apply to the storage and handling of drugs; practical ways of complying in storage, handling and distributing dangerous devices; understand medical terminology as it relates to prescriptions, appropriate abbreviations, dosages and format. To register:
      http://member.campsone.org/cgi-shl/TWServer.exe?EREG:OrderEvent:EX-SD

      Data and Market Intelligence You Can’t Get Anywhere Else!
      The tools and strategies you need to drive revenue and cut costs are at the 2010 HME News Business Summit. We deliver real-life case studies, original research and industry benchmarks. Join your peers for two days of top-notch education and networking.
      Nashville Hilton Downtown
      Nashville, Tenn.
      To review the educational program: http://www.hmesummit.com/speakers.html
      To register: https://www.b2bmediaportal.com/hmesummit/hmesummit.aspx

      Four conferences in one week. Choose your specialty or area of interest: Sleep Conference; Asthma Education;Home Care Conference; Respiratory Care Conference
      Earn at least six CRCE/CEUs everyday
      Location: Blue Ridge Shadows, Front Royal, Va.
      Visit us on the Web at: www.valleyhealthlink.com/brs
      Contact us at: brs@valleyhealthlink.com
      or Call (540) 536-8941

      5-6 reception, 6-8 dinner, Hilton Irvine Orange County Airport, 18800 Macarthur Blvd, Irvine
      CAMPS invites you to attend a special mixer for an update on the state's budget issues impacting the Medi-Cal program and program changes that impact DME and medical supplies. Special guest speaker: Norma Torres, assembly member. To registeR:
      http://member.campsone.org/cgi-shl/TWServer.exe?EREG:OrderEvent:RECPDNR2

      AAHomecare teleconference. 2-3:30 p.m. ET. FMI: 703-535-1880

      AAHomecare teleconference. 2:30-4 p.m. ET. FMI: 703-535-1880.

      2010 has been a year of change for oxygen, CPAP and RAD suppliers. Join Andrea Stark for this informative webinar and ensure your respiratory business is operating in compliance with the Medicare program. 11am & 3pm EST. Cost: $99 per conference line. For more information or to register, visit: http://www.miravistallc.com/recent_services.php


      October 2010
      This year's theme: "Barriers to Boomers - How to Overcome and Prosper." The conference will be held at the Ocean Place Resort & Spa in Long Branch, N.J. FMI: www.jamesofnj.org.

      San Francisco, Calif.
      Anyone applying for an exemptee license through the Department of Health Services and is responsible for overseeing prescription devices should be sure to attend this seminar. After this training program, attendees will be knowledgeable of the U.S. Pharmacopoeia standards that apply to the storage and handling of drugs; practical ways of complying in storage, handling and distributing dangerous devices; understand medical terminology as it relates to prescriptions, appropriate abbreviations, dosages and format. To register:
      http://member.campsone.org/cgi-shl/TWServer.exe?EREG:OrderEvent:EX-SF

      With the recently released Round 1 bid amounts scheduled to be implemented in 2011 and the Round 2 bid window set to open next spring, Competitive Bidding is moving full speed with almost no signs of stopping. During this webinar, Andrea Stark will discuss what all DMEPOS suppliers need to know about the Competitive Bidding program, even if you don’t win a contract or plan to bid. 2pm EST. Cost: $99 per conference line. For more information or to register, visit: http://www.miravistallc.com/recent_services.php


      November 2010
      This webinar will help suppliers ensure they have a clear understanding of Medicare’s current coverage criteria for mobility assistive equipment. In addition to ensuring the patient meets coverage criteria, mobility suppliers will also learn which documents they must have on file in the event of an audit, and how to walk the fine line between “educating” and “leading” the physician. 3pm EST. Cost: $99 per conference line. For more information or to register, visit: http://www.miravistallc.com/recent_services.php

      Georgia World Congress Center in Atlanta.
      Medtrade connects the HME industry. Stay ahead of HME industry changes and find the latest tools to help your clients. Join us at the largest home medical equipment even in the western US as we bring more exhibitors, more ideas, and more products than ever before.
      Visit www.medtrade.com for more information and to register.

      ACHC is pleased to announce a new DME workshop, "Make your Accreditation Work for You," on November 15, 2010. This half day workshop, which coincides with Medtrade in Atlanta, is designed to help providers prepare for ACHC Accreditation and is perfect for companies that are renewing accreditation or applying for the first time. In addition to covering ACHC Accreditation Standards, Tim Safley will guide providers through the accreditation process and also demonstrate how accreditation is more than just a requirement. Accreditation can save valuable time and money, give companies a competitive edge and show strengths and opportunities for improvement. Ample question and answer time will be provided during lunch. Experience the ACHC difference and discover all the ways ACHC is working to add value to accreditation.
      Providers attending this workshop will also receive a free expo pass for Medtrade. Workshop registration information can be found at www.achc.org. For more information, please contact Stacey Hahn at (919) 785-1214 or at shahn@achc.org.

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