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Tag: review

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Jurisdiction B releases review results for support surfaces, CPAP devices

August 22, 2014HME News Staff

YARMOUTH, Maine - Group 2 pressure reducing support surfaces had a claims error rate of 73.7% from April 1, 2014, to June 30, 2014, the Jurisdiction B DME MAC has reported. Top denial reasons included insufficient documentation of larger or multiple stage III or stage IV pressure ulcers on trunk or pelvis that have not improved over the last month, and insufficient documentation due to a missing signature. CPAP devices had a claims error rate of 67% for the same timeframe, the MAC reported. Top denial...

CPAP Devices, Jurisdiction B, review, support surfaces

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OIG outlines work plan

February 4, 2014HME News Staff

WASHINGTON - The Office of Inspector General (OIG) has several new HME-related projects in the works for 2014, including a review of the reasonableness of the Medicare fee schedule.In its recently released 2014 Work Plan, the OIG says it will review the reasonableness of the Medicare fee schedule for certain HME, including commode chairs, folding walkers and transcutaneous electrical nerve stimulators. It will compare what Medicare pays for those items with what non-Medicare payers, such as private...

Medicare payments, OIG, Requirements, review, work plan

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Specialty Providers

Contractor: CPAP claims get 'big F'

September 26, 2010Theresa Flaherty, Managing Editor

NASHVILLE, Tenn. - More than half of all CPAP claims in Jurisdiction C--63.94%--failed in a recent widespread review. "Obviously, that's a big 'F,' said Kelly Riley, director of The MED Group's National Respiratory Network. "Some of the things we should know at this point, but there's also still some confusion and cleaning up we need to do." The review, conducted by Cigna, the Jurisdiction C DME MAC, looked at delivery documentation, detailed written orders, medical necessity, patient/caregiver...

CPAP, CPAP, review

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