AAH adds muscle to audit fight

WASHINGTON - AAHomecare plans to go live with its HME Audit Key on Jan. 15, ready to harness the power of numbers in the industry's fight against out-of-control audits.

Forty-four HME companies have registered to use the tool so far, but AAHomecare believes the official launch and support from industry allies like Brightree, The VGM Group and The MED Group, and Medrade will prompt more companies to do the same.

“I think we'll definitely have an uptick in participation,” said Kim Brummett, vice president of regulatory affairs for the association.

In the ramp up to the live launch, 14 companies—one national company, with a mix of regional and smaller companies—imported their data into the tool successfully.

To further increase participation, in the second quarter AAHomecare plans to launch a companion tool, the Audit and Appeal Mapping System, to help HME companies collect the data needed for the HME Audit Key, like how many audits they have at the different levels of appeals and how many appeals they have won.

“We have found that most companies are tracking the data in some form or fashion, but what we're trying to do is create a standard,” Brummett said.

Preliminary findings from the 14 companies that have successfully used the tool include an 80% appeal rate and a corresponding 92% overturn rate for MAC prepayment denials for respiratory products.

“This data will be unbelievable to CMS,” said Laura Williard, senior director of regulatory affairs and contracting for Greensboro, N.C.-based Advanced Homecare, one of the 14 companies. “It will send a powerful message that we're committed to working with them to resolve issues around audits.”