Tag: Noridian
In brief: AAH on cath fraud & CCS on GLP-1s
March 8, 2024HME News Staff
WASHINGTON – AAHomecare has issued a statement affirming its support for the government to implement real-time monitoring of claims to detect potential fraud and abuse, in response to news reports of potential Medicare fraud by a handful of intermittent catheter companies.
AAHomecare's statement, which was shared with CMS and Capitol Hill, also reiterates recommendations for federal government initiatives to better monitor DME supplier billing practices and trends, including:
Increased...
CMS re-awards contract to Noridian
March 7, 2024HME News Staff
FARGO, N.D. – Noridian Healthcare Solutions has again been awarded the DME MAC for Jurisdiction D contract by CMS. The $152.8 million contract covers 17 states and three U.S. Territories. Noridian processes more than 13 million fee-for-service (FFS) claims for nearly 25,000 DME suppliers, resulting in $2.6 billion in payments for the contract. “We are immensely proud to receive this re-award,” said Noridian president and CEO Jon Bogenreif. “For nearly two decades, Noridian...
Philips recall: Noridian provides guidance
June 28, 2021HME News Staff
WASHINGTON – Noridian Healthcare Solutions has posted FAQs for Jurisdictions A and D on the impact of the Philips recall on coverage and billing for Medicare beneficiaries, AAHomecare has reported.
Among the questions in the FAQ:
How should DME suppliers address the situation with Medicare beneficiaries who are in the first 90-days adherence metric in the PAP and RAD Local Coverage Determinations (LCDs)?
Response: During the Public Health...
Noridian releases error rates
September 6, 2018HME News Staff
FARGO, N.D. - Parenteral nutrition tops the list of error rates recently released by the Jurisdiction D DME MAC Noridian, AAHomecare reports. Codes B4185, B4193, B4197 and B4199 had a 100% error rate from TPE audits for the second quarter of 2019. Right behind parenteral nutrition was surgical dressings with an 86% error rate; hospital beds with a 72% error rate; and glucose monitors with a 65% error rate. AAHomecare did note that the error rates for enteral nutrition (20%) and manual wheelchairs...
SMRC: Noridian is in, StrategicHealthSolutions is out
May 11, 2018Liz Beaulieu, Editor
FARGO, N.D. - Noridian Healthcare Solutions has taken over yet another CMS contract.The company, which is already the Medicare Administrative Contractor for jurisdictions A and D, and the Pricing Data Analysis and Coding contractor, among other things, has been awarded a $227 million contract to be the new Supplemental Medical Review Contractor.“Noridian has extensive DME experience in the field, so this is definitely in their wheelhouse,” said Andrea Stark, a reimbursement consultant...
Noridian named new SMRC contractor
March 23, 2018HME News Staff
FARGO, N.D. - Noridian Healthcare Solutions has been awarded a $227 million Supplemental Medical Review Contractor (SMRC) contract by CMS. The primary role of the SMRC is to conduct nationwide medical review of Part A, Part B and DME providers as directed by CMS. Its responsibility is to review medical records and related documentation to ensure that claims are processed in accordance with CMS guidelines. The SMRC contract was previously held by StrategicHealthSolutions. To support the new contract,...
It's a bumpy start for prior authorizations
March 10, 2017Liz Beaulieu, Editor
WASHINGTON - CGS and Noridian have begun accepting prior authorization requests for K0856 and K0861, but complex rehab providers say they still don't have all the information they need to comply with the program.The contractors on March 6 began accepting requests for dates of delivery on or after March 20.“We're as prepared as we can be, with all the unanswered questions,” said Doug Westerdahl, president and CEO of Rochester, N.Y.-based Monroe Wheelchair, who, because of the uncertainty,...
Here come the 'Super MACs'
January 29, 2016Liz Beaulieu, Editor
YARMOUTH, Maine - Industry stakeholders are weighing the recent shake up in the DME MACs.
For the first time ever, there will be two contractors handling claims processing for all four jurisdictions: CGS Administrators and Noridian Healthcare Solutions.
“This is definitely a big change,” said Wayne van Halem, president of The van Halem Group. “The four jurisdictions have been around since 1993 and there have always been four unique companies doing it. (CGS and Noridian) have...
Short takes: Medtrade, Noridian, AAHomecare, NSM
September 18, 2015HME News Staff
Medtrade will have a dedicated area for showcasing point-of-purchase displays. “Ideas in Caretail: Point-of-Purchase and Small Spaces” will be offered in cooperation with The VGM Group and KC Fixtures. Medtrade will take place Oct. 26-29 at the Georgia World Congress Center in Atlanta…Noridian Healthcare Solutions has been re-awarded a contract for Jurisdiction D. It has administered the contract since 2006, processing claims for 17 states in the Midwest and West, plus American Samoa,...
Noridian publishes review results for enteral nutrition, oxygen, test strips
June 17, 2015HME News Staff
FARGO, N.D. - Noridian Healthcare Solutions, the Jurisdiction D DME MAC has published the results of prepayment reviews for a number of products from January through April 2015. Parenteral nutrition (B4185 and B4197) had error rates of 92% and 98%, respectively. Oxygen (E0434 and E0439) had error rates of 51% and 63%, respectively. Blood glucose test strips (A4253) had an error rate of 87%.