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Tag: ABN


MACs ease denial process for oxygen claims

May 11, 2018HME News Staff

WASHINGTON - The DME MACs are adding modifiers that will allow HME providers to provide additional information related to the coverage and/or liability when the policy criteria are not met for oxygen patients.“The benefit of this change is that suppliers can now file an oxygen claim when a patient doesn't qualify and get an accurate PR (patient responsibility) denial,” AAHomecare wrote in a bulletin.Effective for claims with dates of service on or after Aug. 1, providers should use:the...

ABN, Denials, Oxygen claims

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Reporter's notebook: Loyal customers, the ABN and creativity

September 12, 2014Liz Beaulieu, Editor

YARMOUTH, Maine - Suppose you were an HME provider supplying a Medicare beneficiary with oxygen therapy through a competitive bidding contract. Suppose the beneficiary also needs non-prescription items like a hospital bed, mattress and other HME for which you don't have contracts.Suppose the beneficiary and his or her children want to continue doing business with you, even though you don't have the contracts. What are your options?“You can't sell the equipment to the patient, so we sell the...

ABN, Cash Sales, Competitive Bidding

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Take PECOS seriously, stakeholders say

November 8, 2013Liz Beaulieu, Editor

WASHINGTON - CMS has set a new start date for denying DME claims with the names of physicians who are not enrolled in PECOS and, this time, it may stick, industry stakeholders say.Starting on Jan. 6, 2014, claims with the names of physicians who are not enrolled in PECOS will be denied, and the provider who submitted the claims will not be paid for the items or services that were furnished. Most recently, CMS had planned to start denying claims on May 1, 2013.“It feels real this time,”...

aahomecare, ABN, Andrea Stark, CMS, DME, Kelly Wolfe, Kim Brummett, PECOS, Regency Billing and Consulting

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Filling the void left by The Scooter Store

May 10, 2013Elizabeth Deprey

NEW BRAUNFELS, Texas - When The Scooter Store, the industry's largest provider of power mobility devices, is wounded, what does it mean for those providers left standing?So far, it has meant more Scooter Store customers seeking them out for repairs. Since a layoff this spring that reduced staff at the company to 300 employees, customers are having trouble reaching a live person—so much so that the provider posted a do-it-yourself repair FAQ on its website in April.“We've gotten a lot...

ABN, DME, HME, Network Medical Supply, Southwest Mobility, The Scooter Store, Upstate Rehabilitation Products

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Pulmonologists blacklisting providers? Beneficiaries taking CPAPs hostage? The crazy world of compliance.

December 8, 2009Theresa Flaherty, Managing Editor

It's been just over a year since Medicare's new compliance requirements went into effect for CPAP. Over the past year, I have checked in regularly with CPAP providers to see how its going. For the most part, providers take the good with the bad and simply try to take care of patients. However, I never fail to be amazed at the disconnect between Medicare/physicians/beneficiaries, with the provider stuck firmly in the middle. Kelly Riley, director of the MED Group's National Respiratory Network forwarded...

ABN, Compliance, CPAP, CPAP, e-SP, Medicare, Medicare

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Executive Session

We've cut our staff, and I'm working my butt off

July 20, 2009Mike Moran

Phantasm III: Lord of the Dead the movie No one will ever accuse Vince DeStigter of not speaking his mind. The 67-year-old owns and operates Western Healthcare and has been a provider for almost 40 years. These days he's plenty fed up with the state of the industry, and he called me recently to let off some steam. Here's what he had to say: One Hour Photo movie download If they keep on cutting our benefits, you know what, let them cut it, but let us all get together and say, 'Let us charge the...

ABN, ABN, Advance Beneficiary Notice, Executive Session, Ron Reed, Western Healthcare

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