Skip to Content

Tag: NHIC


Also Noted

DME MAC issues face-to-face clarification

September 18, 2014HME News Staff

WASHINGTON - The face-to-face requirement only applies to written orders for Medicare payment, according to a bulletin from AAHomecare. "This clarification means that when a state has a prescription requirement annually, a new face-to-face is not required," the association stated. The guidance comes from the NHIC, the Jurisdiction A DME MAC. Even though a supplier does not need a new face-to-face evaluation, it must still obtain a new order and remain in compliance with state regulations, according...

aahomecare, face-to-face rule, NHIC


Read Full Articlered right arrow icon

Also Noted

DME MAC releases oxygen, CPAP review data

May 29, 2014HME News Staff

HINGHAM, Mass. - NHIC found a 44% denial rate for oxygen and oxygen equipment as part of a review of claims filed between Jan. 1, 2014, and March 31, 2014. The Jurisdiction A DME MAC reports responses to additional documentation requests were not received for 59% of the claims. For the same time period, the NHIC found a 64.3% denial rate for CPAP devices. Oxygen claims were most frequently denied for missing documentation; failing to meet written order prior to delivery requirements; and failing...

CPAP, NHIC, Oxygen, Oxygen equipment, Prepayment review


Read Full Articlered right arrow icon

News

Appeals court sides with CMS contractor

November 16, 2012Leif Kothe

PHILADELPHIA - The U.S. Court of Appeals for the Third Circuit has rebuffed a former HME provider who fought an audit and won, then filed a $10 million lawsuit against the CMS contractor that conducted the audit.Dominic Rotella, the owner of Nichole Medical Equipment, which was improperly audited by TriCenturion and subsequently went out of business, says the outcome of the case threatens not only the HME industry, but any industry that contracts with CMS.“This is no longer about TriCenturion...

Dominic Rotella, NHIC, Nichole Medical, tricenturion, U.S. Court of Appeals for the Third Circuit


Read Full Articlered right arrow icon

Also Noted

DME MAC reports latest denial rate for K0823

October 4, 2012HME News Staff

HINGHAM, Mass. - Seventy-four percent of the claims for K0823 submitted in Jurisdiction A between April 2012 and June 2012 were denied, according to a widespread prepayment review by NHIC. The review examined 514 claims submitted by 188 suppliers. The most common reasons for denial had to do with issues with documentation (56%), the seven-element order (30%), detailed product description (18%) and the delivery ticket (9%).

CMS, DME, NHIC


Also Noted

DME MAC reports latest denial rate for K0823

October 4, 2012HME News Staff

HINGHAM, Mass. - Seventy-four percent of the claims for K0823 submitted in Jurisdiction A between April 2012 and June 2012 were denied, according to a widespread prepayment review by NHIC. The review examined 514 claims submitted by 188 suppliers. The most common reasons for denial had to do with issues with documentation (56%), the seven-element order (30%), detailed product description (18%) and the delivery ticket (9%).

CMS, DME, NHIC


Executive Session

If I'm an idiot, what is CMS?

June 14, 2010Mike Moran

A few weeks ago, I was sitting at my desk at HME News' world headquarters here in Yarmouth, Maine, when as often happens, my phone rang. I picked up the receiver and said, "Hello, this is Mike." The woman on the other end identified herself as the DME trainer for Jurisdictions A&B. She worked, she told me, for National Government Services (the Jurisdiction B MAC, which serves 19,500 DME suppliers) and also for the NHIC (the J14 MAC for New England). She seemed very nice and very competent. After...

Emerge Sales, Executive Session, Janice S. Ahlstrom, NHIC, straight dope


Read Full Articlered right arrow icon