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Sylvia Toscano

Stakeholders pound pavement in Florida


TALAHASSEE, Fla. – The state of managed care in Florida motivated Sylvia Toscano, a long-time industry consultant, to visit the state capitol for the first time in January.

Auditors avoid appeals process, make ‘major’ requests


YARMOUTH, Maine – If you’re an HME provider trying to appeal a denial by a managed care payer, it’s probably not going very smoothly, reports consultant Wayne van Halem.

Notes from the field: diversification and billing


Medicare: Take it or leave it

Provider Roger Lichty has slowly transformed his business over the past few years so that vehicle mobility is now his No. 1 business.

DME MAC launches manual wheelchair prepay probe


INDIANAPOLIS – Few providers in Jurisdiction B seem to be affected so far by a recent prepayment review for manual wheelchair bases, including the adult tilt-in-space models, coded E1161.

Reporter's notebook: Crash course in charting and other calamities


For years, HME providers have been trying to teach physicians what they need to include in their chart notes, often to no avail, says Sarah Hanna, president of ECS Billing & Consulting North.

Collecting at any cost

‘You’ll do whatever it takes to get that money’

YARMOUTH, Maine – When provider Tammy Zelenko gets ready to close the books on her fiscal year every June, she strives to close out outstanding patient balances.

Sometimes, that means offering a discount to patients to get them to pay up.

Medicare permits walker upgrades


Persistence paid off in this case. Below is the final determination from Medicare since the initial HME News article (“Unbundling trips up providers,” December 2013). 

Providers avoid shortened timeframe

CMS had wanted to require them to respond to initial documentation requests in 60 days

WASHINGTON – It looks like the timeframe for responding to initial documentation requests as part of the Comprehensive Error Rate Testing (CERT) program will stand at 75 days.

Different take on unbundling


In response to your story “Unbundling trips up providers” (HME News, December 2013), I would like to draw your attention to the following clarification from the Jurisdiction B DME MAC: