Tag: Billing
Outsourcing goes from cost cut to core strategy
November 19, 2025Tracy Orzel
Key highlights:
Outsourcing becomes strategic: Providers increasingly view outsourcing as essential for sustainability amid staffing shortages, payer audits and rising operational complexity.
Labor and expertise challenges: High turnover, costly onboarding and specialized billing requirements push providers toward partners with deep industry knowledge and process expertise.
Tech-plus-people approach: Successful outsourcing blends...
OIG report urges monitoring of remote patient monitoring
September 2, 2025HME News Staff
WASHINGTON – The use of remote patient monitoring continued to grow in 2024, with Medicare payments exceeding $500 million, according to a new report from the HHS Office of Inspector General.
Other key takeaways from the report:
Monitoring billing can help safeguard the Medicare program and prevent fraud, waste and abuse.
Billing that may warrant further scrutiny includes billing for a high proportion of enrollees who have no prior history with the medical practice...
Allegiance Group integrates with R2Health
August 25, 2025HME News Staff
OVERLAND PARK, Kan. – Allegiance Group has announced that its COLLECTPlus platform is now integrated with R2Health’s software to streamline billing and improve cash recovery for infusion providers. “We are excited to partner with R2 Health to bring our proven patient billing and collection strategies to their network of specialty infusion providers,” said Bruce Gehring, SVP of business development at Allegiance Group. “Through our COLLECTPlus integration, providers can...
In brief: ACU-Serve merges, Hoveround & Merits partner, ATLAS Technology rebrands
August 6, 2025HME News Staff
AKRON, Ohio – ACU-Serve has merged with Pinnacle Revenue Management, a provider of home infusion and ambulatory infusion center billing services.
"This merger marks a pivotal moment for both ACU-Serve and the infusion industry,” said Jim Knight, president and CEO of ACU-Serve. “By uniting our expertise, talent and technology, we are not only setting a new benchmark for excellence and innovation but also reaffirming our commitment to high-touch service and operational...
Nymbl Systems receives investment
December 23, 2024HME News Staff
COLUMBUS, Ohio – Nymbl Systems, a provider of cloud-based practice management software for orthotics and prosthetics, complex rehab technology and home medical equipment providers, has received an equity investment from Frontier Growth.
The amount of the deal was not disclosed, but Charlotte-based Frontier Growth typically makes initial equity investments of $5 million to $30 million in mission critical vertical SaaS companies with $3 million to $20 million of annual recurring revenue...
Billing: Manage your risk
December 10, 2024Kit Shellhouse
Q. How can I stay compliant with Medicare’s fee-for-service plans?
A. Dealing with Medicare fee-for-service plans can be tricky, but there are ways to manage the risks and stay compliant. Documentation errors are a primary risk, as Medicare is extremely strict, and any mistakes can lead to claim denials or audits. To avoid these risks, ensure all patient records, prescriptions and proof of delivery are thoroughly documented and easily accessible. Billing inaccuracies, such as incorrect...
Billing software: Advancements needed, respondents say
December 6, 2024Liz Beaulieu, Editor
YARMOUTH, Maine – When it comes to a wish list for their billing software, the respondents to a recent HME Newspoll say it’s all about integrating various capabilities, doing more to leverage artificial intelligence and streamlining their costs.
Respondents reported they’d like to see their billing software integrated with other programs that manage everything from appointments to patient therapies to electronic signatures to mask fittings.
“I would like...
Billing: Protect PHI
October 16, 2024Kit Shellhouse
Q. What types of information will I be required to provide to the OCR in the event of an audit of my HIPAA compliance program?
A. Being proactive will alleviate the pressure of an OCR (HSS Office for Civil Rights) audit. The OCR will request documentation from you as a provider. This information must demonstrate that your company has adhered to the required HIPAA Program.
To prove adherence, a portion of the required documentation will include the policies and procedures related...
CMS issues final rule on catheter billing
September 26, 2024HME News Staff
WASHINGTON – CMS has issued a final rule that addresses suspicious billing activity within the Medicare Shared Savings Program that resulted in an increase in DMEPOS billing for certain intermittent urinary catheter supplies. The rule, “Medicare Program: Mitigating the Impact of Significant, Anomalous, and Highly Suspect Billing Activity on Medicare Shared Savings Program Financial Calculations in Calendar Year 2023” (CMS-1799-F) is part of a larger strategy to address significant,...
Noridian responds to orthotics inquiries
September 23, 2024HME News Staff
WASHINGTON – Noridian Healthcare Solutions has published an update for billing custom-fitted orthotics when no custom fitting is completed with no off-the-shelf equivalent available. “Due to recent inquiries from suppliers, it has come to our attention that some miscellaneous codes used for billing off-the-shelf orthotics, when a custom fit orthotic is provided but no custom fitting is performed, may require specific policy and laterality modifiers,” it states. These claims must...