Medical Review FAQs - Spring 2013 Q1. Our PMD Prior Authorization (PAR) request was non-affirmed because our documentation did not include a financial attestation statement. When a portion of the face-to-face examination is performed by a licensed/certified medical...
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Stay informed with Medbill’s blog, where we share expert guidance, practical tips, and industry updates to help DME providers navigate the industry’s complexities.
Reimbursement
ICD-10 Deadline Confirmed By CMS Administrator
As the dust from HIMSS13 settles, CMS would like to thank everyone who stopped by our booth to say hello and discuss the ICD-10 transition and the future of eHealth with us. In case you weren't able to get to the booth, here are some of the highlights from the...
Are You Prepared for the May 1st PECOS Edits?
After a brief announcement and retraction, CMS settled on May 1, 2013, as the day that phase two of the Internet-based Provider Enrollment, Chain, and Ownership System (PECOS) will go into effect. As of that date, CMS will deny HME, Part B, and Part A home health...
Competitive Bid Rates Reduced by 2%
On March 8th CMS notified Durable Medical Equipment (DME) Providers that reimbursement rates for all claims submitted will be reduced by 2% beginning April 1st, 2013. These latest cuts are part of the Sequester, mandatory across-the-board cuts in federal spending....
HHS Moving To Offer Affordable Coverage In 2014
Health and Human Services (HHS) Secretary Kathleen Sebelius today announced that more states are moving forward to implement the health care law and establishing Health Insurance Marketplaces. HHS conditionally approved Iowa, Michigan, New Hampshire, and West Virginia...
VA To Reduce Verification Denials Using Preliminary Findings
WASHINGTON - To speed eligibility determinations of Veteran-owned small businesses for Department of Veterans Affairs' “Veterans First” contracts, VA will allow applicants the opportunity to correct minor deficiencies before an initial denial is issued. Starting May...
CMS 2013 Fee Schedules
CMS has released 2013 fee schedules on it’s website. You can view the changes by clicking here. The rates have been adjusted for inflation and several key product classes have seen an increase in reimbursement. The new rates are effective January 1st, 2013.
Blue Cross Plan Changes
The national blue cross organization has instructed all state blue cross plans to change the processing methods for out of state claims. What you should do: Make sure you verify all your patient addresses. If they are not in the state where you are providing services,...