Health Care

CMS/Medicare

5 Steps to Audit-Proof Every Claim

Be proactive to avoid unnecessary delay

CMS/Medicare

Reduce Your Denials

Take action and reap major rewards for your company

CMS/Medicare

Can Insurance Carriers Perform Audits the Way Medicare Does?

Providers be aware that insurers must follow certain statutes and regulations under ERISA

A Foolproof Solution to Home Health’s Billion-Dollar Fraud Problem

CMS/Medicare

A Foolproof Solution to Home Health’s Billion-Dollar Fraud Problem

Proof of presence

CMS/Medicare

Additional Documentation Requirements

Stay aware of medical coverage changes and what written proof you need upon request.

CMS/Medicare

Audit Relief Legislation

Potential reform is on the horizon for the DMEPOS auditing process

CMS/Medicare

Understanding the Importance of the Provider Enrollment Process

Signed, sealed, denied: buyer beware

CMS/Medicare

New PECOS Accreditation Process Takes Effect Jan. 6

Enroll to avoid being denied by CMS

Health Care

After Health Care Reform: Developing Merger and Acquisition Strategies

Explore these mergers and acquisitions options in the new era of affordability

Health Care

Connectivity Drives Compliance

CPAP and sleep market looking to the broader implications of health-care changes

Health Care

Pelton's Home Health Care

This company has survived by following the customers’ lead

CMS/Medicare

TENS Unit HCPCS E0720 and E0730

Transcutaneous Electrical Nerve Stimulation (TENS) Devices, HCPCS E0720 and E0730, are challenging items to get paid.

CMS/Medicare

PR16 Claim service lacks information needed for adjudication

National Government Services, the Jurisdiction B DME MAC, recently addressed issues with claims filing resulting in a PR16 denial code with an M124 remark code.

CMS/Medicare

CO13 / OA13: Date of death precedes date of service

There isn't too much room to dispute Medicare when you receive this denial code.

CMS/Medicare

CO16: Claim/service lacks information which is needed for adjudication

CO16Claim/service lacks information which is needed for adjudication The CO16 denial code alerts you that there is information that is missing in order

CMS/Medicare

CO 50: Non-covered services not deemed a medical necessity

CO 50, the sixth most frequent reason for Medicare claim denials, is defined as: non-covered services because this is not deemed a medical necessity by

CMS/Medicare

OA109: Claim not covered by this payer/contractor

The second highest reason code for Medicare claim denials reported for HME providers is OA109: claim not covered by this payer/contractor. You must send

CMS/Medicare

Apria to Pay $17.6 Million to Settle Charges

Lake Forest, Calif. Apria Health-care has reached a preliminary agreement with the government and whistleblowers to pay $17.6 million, without admitting