Tag: MiraVista

COLUMBIA, S.C. – The Provider Relief Fund Reporting Portal is open, but right now, providers can only register on the website, according to MiraVista. The Department of Health and Human Services hasn’t specified when reporting features will be available, but providers that received more than $10,000 from the PRF should register now to receive email notifications and updates, the consulting firm says. Because the portal times out after 15 minutes of inactivity, MiraVista recommends...

MODESTO, Calif. - It's not every day that HME providers get good news from a CMS audit contractor, but Home Oxygen Company recently got a break from certain audits.The provider recently received word from Noridian, the Jurisdiction D MAC, that it had earned 12-month reprieves from widespread prepay reviews for both oxygen and CPAP.“It's a confidence builder,” said Andrea Ewert, CEO. “We are doing what they like, and we are going to keep it up.”Ewert plans to use the reprieve...

Since it's been so long since HME providers have had to grapple with a RAC, stakeholders offered these pieces of advice:Be proactive. “Suppliers must have an internal quality assurance and compliance program that regularly monitors the claims that are being submitted,” said Wayne van Halem, president of The van Halem Group, a division of The VGM Group. “They should review the RAC website regularly to perform a risk assessment on their proactive audits. Suppliers can minimize the...

YARMOUTH, Maine - Recent revisions to the documentation requirements for CPAP resupplies are a “huge win,” but industry stakeholders want further clarification.CMS will now assume that medical necessity has been established for replacement of accessories for beneficiary-owned CPAP and RAD devices.Still, stakeholders would like to see the agency clarify—in writing—what documentation HME providers still need to get paid for accessories.“You need a detailed written order...

WASHINGTON - Recent guidance from the DME MACs on coverage criteria for ventilators is a move in the right direction, say industry stakeholders.Specifically, the guidance removes the so-called “imminent death requirement,” which stated that patients must need a ventilator 24/7 for coverage.It's a requirement the MACs issued in April 2015 in an attempt to define criteria for vents vs. bi-level devices.The new guidance doesn't go that far, but “makes very clear that any device which...

MiraVista, a consulting and outsourced billing company for DME providers, has redesigned its website to make its industry updates, and education events and tools front and center. The new site is also mobile friendly…PMDRX recently demoed its mobility exam and documentation technology to the office of U.S. Rep. Trent Franks, R-Ariz. With help from Franks' office, PMDRX has completed an application for a $250,000 Arizona Innovation Challenge grant that would allow it to launch an aggressive marketing...

Do you want to know what the regional pricing might look like under the national rollout of competitive bidding scheduled to take place Jan. 1, 2016? Andrea Stark, a reimbursement consultant with MiraVista, can give you a pretty good idea. In a webcast that aired on Jan. 13 and that is still available on demand, Stark walked attendees through an example of what the pricing for oxygen concentrators (E1390) might look like in Bartlesville, Okla., part of the Southwest Region, one of eight regions included...

WASHINGTON - It was a big win in the HME industry's fight against competitive bidding when CMS disqualified one-third of the contract suppliers for Tennessee, but that's not the only state with licensure issues, stakeholders point out.“It establishes a precedent that CMS is going to have to deal with,” said Andrea Stark, a reimbursement consultant with MiraVista. “I see it as a domino falling, the beginning of a chain reaction.”CMS last week sent letters to 30 contract suppliers...

YARMOUTH, Maine - Some Medicare Advantage (MA) plans are starting to look more and more like traditional Medicare, industry sources say.In the wake of CMS's announcement of the Round 2 payment amounts, a Blue Cross Blue Shield MA plan in one state, for example, has shaved 10% off its reimbursement for HME. Another plan going in that direction: Windsor, says Tyler Poole.“We anticipated this,” said Poole, vice president of operations for Benefits365, a company that helps providers shift...

WASHINGTON - The proper use of advance beneficiary notices (ABNs) has shifted—and not in the HME provider's favor, industry stakeholders say.CMS has evolved its policy to the point where providers can no longer use ABNs to “upgrade” within the same code, says Andrea Stark, a reimbursement consultant with MiraVista.“We are operating in gray areas,” she said. “It has definitely been an erosion of how we utilize this.”Case in point: In January, the PDAC expanded...