Tag: Documentation
Industry on home oxygen: We need ‘objective standards for review’
October 5, 2021HME News Staff
WASHINGTON – AAHomecare, VGM & Associates, the Council for Quality Respiratory Care and 11 other organizations are asking CMS to eliminate the medical record review for home oxygen therapy and to accept the clinician prescription/standard written order as the required documentation for establishing medical necessity.
These changes would protect against fraud and abuse, reduce the burden on clinicians and suppliers, and protect access for Medicare beneficiaries, the groups say in an...
DME MACs drop CMNs for oxygen, infusion services
May 12, 2020HME News Staff
WASHINGTON - The DME MACs on May 7 announced that they will not require CMNs for oxygen claims during the COVID-19 public health emergency.The update follows CMS's decision not to enforce clinical indications of coverage for the oxygen NCDs and LCDs, as outlined in an April 6 interim final rule.“After carefully reviewing the CMN and the related claims processing issues that would result from having missing information or having clinical information for which the form was intended, CMS has determined...
van Halem Group, Ossur partner to improve O&P documentation
February 26, 2020HME News Staff
ATLANTA - The van Halem Group will provide clinical prescreen reviews and appeal services for custom orthotics and prosthetics provided by Ossur's customers.The services will include, but will not be limited to, a prescreen review of documents to determine if all coverage requirements have been met prior to submission for reimbursement, as well as access to the van Halem Group's team of clinical experts.“We know all too well the challenges and hurdles our customers face when submitting claims...
WellSky on breaking down 'electronic silos'
January 14, 2020Liz Beaulieu, Editor
OVERLAND PARK, Kan. — A new framework for interoperability from WellSky allows its provider customers to better communicate across various patient data exchanges — all electronically. Here's what Amy Shellhart, senior vice president of product management, had to say about how WellSky I/O is helping to break down “electronic silos” of documentation, significantly advancing efforts to achieve what the company calls “true interoperability.”HME News: As we know, there...
AAH: Keep using WOPDs—for now
January 14, 2020HME News Staff
WASHINGTON - AAHomecare recommends that providers continue to obtain written orders prior to delivery for HME until CMS publishes a “required list.”Earlier this month, the DME MACs said a new standard written order would be the only type of order needed for HME claims starting with dates of service Jan. 1, 2020. But it also said certain HME on a “required list” would still be subject to face-to-face and WOPD requirements.While AAHomecare has confirmed that as of Jan. 1, 2020,...
CMS ushers in Standard Written Order
January 7, 2020HME News Staff
WASHINGTON - Only one type of order is now needed for DMEPOS claims, starting with dates of service Jan. 1, 2020, according to the DME MACs.To help reduce provider burden, a new Standard Written Order (SWO) replaces the following types of orders:preliminary/dispensing order;Detailed Written Order;Five Element Order/Written Order Prior to Delivery; andSeven Element Order and Detailed Product Description.The DME MACs say providers should refer to the new Standard Written Order requirements and Standard...
SMRC warns of audit risk—for ordering practitioners
January 7, 2020HME News Staff
ATLANTA - The SMRC is holding ordering practitioners accountable and acknowledging that provider payments for DMEPOS are reliant on their documentation, the van Halem Group reports.The requirement for practitioners to comply with a provider's request for documentation has been part of the Program Integrity Manual for some time, but in its most recent project detail for diabetic test strips, the SMRC says:“If a practitioner doesn't respond to a supplier's request for documentation to support...
OIG criticizes supplier documentation for inhalation drugs
November 5, 2019HME News Staff
WASHINGTON - Not all suppliers comply with Medicare requirements when billing for inhalation drugs, according to the Office of Inspector General. For 81 of the 120 sampled claim lines, suppliers complied with requirements; for the remaining 39 claim lines, 22 suppliers did not comply with requirements. The OIG says the documentation from these suppliers contained incomplete, invalid or missing detailed written orders; incomplete proof of delivery; incomplete refill requests; and no medical records....
In brief: AAH meets with Humana Military, accessories issue clears another committee
July 18, 2019HME News Staff
WASHINGTON - AAHomecare has requested that Humana Military waive the requirement for documentation submission with each subsequent rental month after the initial documentation is received.Humana Military, which manages the Tricare East contract, is currently evaluating the request, the association says.The development comes after Laura Williard, vice president of payer relations, and David Chandler, director of payer relations, met with executive leadership at Humana Military and Wisconsin Physician...
CMS seeks input on paperwork burden, including documentation requirements for payment
June 7, 2019HME News Staff
WASHINGTON - CMS on June 6 issued a Request For Information on how to streamline regulations and cut the “red tape” that weighs down the healthcare system.The agency says it wants to continue the progress of Patients over Paperwork, an initiative that it launched in 2017 and that it says is helping to save an estimated 40 million hours and $5.7 billion through 2021.“Patients over Paperwork remains a top priority and a driving force in lowering healthcare costs,” said CMS Administrator...