Tag: Peggy Walker

WATERLOO, Iowa - The VGM Group's U.S. Rehab will roll out an Audit Task Force at its Heartland Conference, June 9 through June 12, said U.S. Rehab President Greg Packer. Task force members Peggy Walker, Ronda Buhrmester and Dan Fedor will offer billing and reimbursement advice; review claims and audits providers feel were incorrectly denied; answer questions on National Supplier Clearinghouse issues; and offer ongoing educational opportunities for members of VGM and U.S. Rehab.

WATERLOO, Iowa - Seventy-percent of the denials that U.S. Rehab's Peggy Walker sent to C2C Solutions for review following a forum hosted by the Office of Medicare Hearings and Appeals (OMHA) have been overturned fully or partially in favor of providers. C2C Solutions is a Qualified Independent Contractor (QIC) that handles the second level of appeals. “C2C Solutions was willing to look over the denials that were made in error,” Walker said. “The errors were technical errors that...

WASHINGTON - CMS on Jan. 6 officially began denying claims with the names of physicians not enrolled in PECOS, and providers say so far, so good.“We've been very fortunate,” said Lori Corey, vice president of finance for Waukesha, Wis.-based Oxygen One. “It's been very smooth.”This phase of PECOS has been years in the making. There have been numerous delays, most recently from May 1, 2013.Those delays have been a big help in allowing providers to get doctors up to speed with...

WASHINGTON - CGS, the Jurisdiction D DME MAC, released an overview of its K0823 prepay review activity this month, and the results are ugly.From the second quarter of 2012 to the second quarter of 2013, the denial rate rose steadily until hitting a peak of 69%. The denial rate fell to 54% for the third quarter of 2013—not much better.These rates transcend jurisdictions, stakeholders say, and are especially troubling considering all of the other pressures that HME providers face in today's market.“No...