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Tag: Performant


News

In brief: RAC audits test strips, Medicare overpays for PSG

June 21, 2019HME News Staff

WASHINGTON - Performant, the national RAC for DME, received approval from CMS on June 14 to audit blood glucose test strips (A4253) nationwide. “The quantity of glucose test strips that are covered depends upon the usual medical needs of the diabetic patient,” reads an announcement on the RAC's website. “Documentation will be reviewed to determine if the utilization guidelines for glucose test strips were met.” The RAC will be reviewing claims that have a “claim...

Aeroflow, ALS Foundation, Ascension, Performant, Permobil, Philips


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Specialty Providers

RAC to audit test strips

June 18, 2019HME News Staff

WASHINGTON - Performant, the national RAC for DME, received approval from CMS on June 14 to audit blood glucose test strips (A4253) nationwide.“The quantity of glucose test strips that are covered depends upon the usual medical needs of the diabetic patient,” reads an announcement on the RAC's website. “Documentation will be reviewed to determine if the utilization guidelines for glucose test strips were met.”The RAC will be reviewing claims that have a “claim paid date”...

Audits, Performant, RAC, test strips


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News

CareCentrix, Performant specialize fraud efforts

May 23, 2017HME News Staff

HARTFORD, Conn. - CareCentrix has teamed up with Performant Financial Corporation, the new national RAC for DME, home health and hospice, to deploy specialized analytics and algorithms to better identify and decrease waste and fraud, it announced May 23.“You only need to look at recent headlines to know that the problems of fraud, waste and abuse are only increasing,” said John Driscoll, CareCentrix CEO, in a press release. “CareCentrix is committed to bending the cost curve in...

Analytics, CareCentrix, Fraud, Performant


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News

In brief: CMS solicits input on reimbursement, nat'l RAC ready to roll

March 10, 2017HME News Staff

WASHINGTON - CMS has scheduled a call to solicit stakeholder input on its methodology for using information from the competitive bidding program for adjusting Medicare fee schedule amounts in non-bid areas.The 21st Century Cures Act mandated that the agency solicit and take into account stakeholder input on future pricing in non-bid areas.The act also mandated that CMS take into account the highest amount bid by a winning supplier in a bid area, as well as make comparisons in bid and non-bid areas...

ALJ Backlog, Performant, Prior auths, Simon Margolis Fellow Award, SoClean


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Also Noted

Performant ready to roll

March 10, 2017HME News Staff

LIVERMORE, Calif. - Performant Recovery, the new national recovery audit contractor for DMEPOS and home health/hospice, announced March 8 that it has officially received approval from CMS to begin audit activity. The RAC in February posted seven new reviews on its workload page: complex medical necessity chest wall oscillation devices; complex medical necessity tracheotomy suction catheters, suction pumps, catheters and other related supplies and equipment; automated nebulizers not in accordance...

Audits, National RAC, Performant, reviews


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New RAC posts new reviews

February 24, 2017HME News Staff

WASHINGTON - Performant Recovery, the new national recovery audit contractor (RAC) for DMEPOS and home health/hospice, has posted seven new reviews on its workload page, according to AAHomecare. They are: complex medical necessity chest wall oscillation devices; complex medical necessity tracheotomy suction catheters, suction pumps, catheters and other related supplies and equipment; automated nebulizers not in accordance with billing requirements; automated DME billed while inpatient; complex review...

Audits, Performant, RAC


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