As if the sheer quantity of audits wasn’t enough to contend with, HME providers often have to untangle inconsistencies in regulations and guidance, says Stephanie Morgan Greene, a healthcare attorney who’s executive vice president of business development for AC
A. To reduce or remove the extrapolation, you will need to appeal the overpayment determination, addressing both the individual claims reviewed in the audit and the extrapolation itself. Consider this a two-tier appeal process.
WASHINGTON – Twelve percent of HME claims for new patients, on average, were subject to MAC prepayment audits in the fourth quarter of 2015, according to data collected through AAHomecare’s HME Audit Key.
A. It is not your imagination! Aside from your standard DME MAC prepay and postpay audits, three contractors in particular have “upped their game,” so to speak, and the DMEPOS community is certainly feeling the pressure.