Tag: Error Rates

WASHINGTON - Enteral nutrition had the highest error rate (87%) from Targeted Probe and Educate audits in Jurisdiction D.Noridian Healthcare Services, the DME MAC for Jurisdiction D, posted the error rates from TPE audits (see below) from Oct. 1 to Dec. 31, 2017.AAHomecare has requested that all the DME MACs publish the error rates.The error rates in Jurisdiction D are:19%, ankle-foot/knee-ankle-foot orthosis (L4360, L4362, L4386, L4387)87%, enteral nutrition (B4150, B4152, B4154)35%, external infusion...

NASHVILLE, Tenn. - CGS Administrators has agreed to make two concessions that should make audits less hair-raising for HME providers in Jurisdiction C.The first: In a June 3 bulletin, the DME MAC detailed its plans to start sending providers detailed written letters explaining why their claims were denied as part of prepayment or complex medical reviews.“We're encouraged that they're taking our feedback and that we're finding those areas where collaboration is possible,” said Andrea Stark,...

When it comes to the HME industry, instead of in with the new and out with the old, it's in with the new and more of the old.For 2013, the new includes a provision in the recently passed "fiscal cliff" deal that extends the look-back period for audits from three years to five years. The old includes a continuing stream of reviews by CMS contractors that result in staggeringly high error rates.But the new also includes this: Providers approaching 2013 with a renewed focus on succeeding by becoming...