Tag: Ronda Buhrmester
Home oxygen therapy: Stakeholders welcome ‘much-needed’ guidance
March 3, 2023Theresa Flaherty, Managing Editor
WASHINGTON – An updated FAQ published by the DME MACs in February, by and large, addresses concerns around the new local coverage determination for home oxygen therapy and serves as a good reference point as HME providers navigate a new era for the benefit, stakeholders say.
The FAQ, published Feb. 21 and updated Feb. 23, addresses 25 questions related to continued need, the new N modifiers and more.
“Full stop, it was a much-needed thing,” said Andrea Stark, a...
Contractors ‘flip switch’ on audits
January 6, 2023Theresa Flaherty, Managing Editor
YARMOUTH, Maine – After lying largely dormant during the public health emergency, audits are on the rise, including for respiratory claims, say industry consultants.
While audits never stopped completely during the PHE, waivers of certain coverage criteria, including for oxygen equipment and CGMs, helped lessen the burden on providers. But UPIC auditors are now increasingly targeting claims covered by those waivers, says Kelly Grahovac.
“It’s almost like they...
Providers should prepare to move on from PHE
September 9, 2022Theresa Flaherty, Managing Editor
WASHINGTON – CMS has begun setting the stage for the end of the public health emergency and so should HME providers, say stakeholders.
The agency recently released an overview, “Creating a Roadmap for the End of the Covid-19 Public Health Emergency,” and while it doesn’t provide new information, it summarizes waivers still in place and those that have already expired.
“Eventually, the PHE is going to come to an end and suppliers need to be thinking...
‘Headache’ will go away for more than just oxygenÂ
June 17, 2022Liz Beaulieu, Editor
WATERLOO, Iowa – Much of the celebration around the elimination of the certificate of medical necessity (CMN) requirement on Jan. 1, 2023, has focused on oxygen concentrators, but four other product categories will also benefit from the change.
Seat lift mechanisms, TENS devices, pneumatic compression devices and osteogenesis stimulators will all no longer require CMNs starting next year.
“It’s a big deal,” said Ronda Buhrmester, senior director of payer...
CMS sunsets CMN for home oxygen
October 1, 2021Theresa Flaherty, Managing Editor
WASHINGTON – CMS on Sept. 27 posted a final national coverage determination for home oxygen, but now industry stakeholders must “wait and see” what the DME Medicare Administrative Contractors do with the changes.
While the effective date of the NCD is technically Sept. 27, it won’t be implemented until a later date, when the DME MACs update their local coverage determinations.
“There are a lot of positives here, and we will wait and see,” says...
‘Take the patient’Â
February 19, 2021Liz Beaulieu, Editor
WATERLOO, Iowa – For HME providers, the need for information and confirmation on waivers related to the public health emergency has ebbed and flowed with surges in COVID-19 cases, says Ronda Buhrmester of VGM Government Relations.
“Back in the spring, the hotspots were big cities and they were the ones dealing with the impact of the pandemic, while other areas were not,” said Buhrmester, senior director of payer relations....
Ronda Buhrmester and the search for solutions
March 27, 2020Liz Beaulieu, Editor
WATERLOO, Iowa - Ronda Buhrmester was one of three speakers, along with Laura Williard and Ty Bello, for a webcast in March on COVID-19 that drew more than 800 attendees. Here's what Burhmester, a reimbursement specialist for VGM, had to say about how the HME industry is trying to keep pace with the dizzying developments around the disease, as well as the changing policies and regulations.
HME News: With so much happening around COVID-19, what was the focus of the webcast?
Ronda Buhrmester:...
Consultant's corner: Providers tackle enrollment, technology in new year
January 24, 2019Liz Beaulieu, Editor
Fighting that fear factorVGM's Ronda Buhrmester spent the last two weeks of 2018 taking frantic calls from HME providers wondering whether or not they should change their Medicare enrollment status for 2019.Her general advice: If you're a participating provider, change to non-participating.“There's a fear factor, because it's a change in enrollment status for a lot of providers, and they're afraid of how it's going to affect their patients and their referrals,” said Buhrmester, director...
Billing: Meet all requirements
August 29, 2018Ronda Buhrmester
A. For ongoing supplies and rented DME items, in addition to information justifying the initial need of the items and/or supplies, there must be information in the medical record to support that the item continues to remain medically necessary. Suppliers are responsible for monitoring utilization of rental items and supplies. Timely documentation is within the preceding 12 months—keep this in mind throughout the article.Continued Medical NeedRecent order by the treating physician for refillsRecent...
Billing: Prepare by self-auditing
July 30, 2018Ronda Buhrmester
A. Don't take for granted the documentation requirements for refill requests. CPAP supplies fall under the non-consumable guidelines, which are more durable requiring periodic replacement. Refills cannot be dispensed automatically; there needs to be communication with the patient to assess the need and must be documented making sure each requested item is being addressed. The request must include the patient's name (or authorized person), date of request, description of each item: non-consumable...