HME News

JUN 2017

HME News is the monthly business newspaper for home medical equipment providers. This controlled circulation publication reaches 17,100 home medical equipment services providers, including traditional HME dealers & suppliers, hospital- and pharmacy-o

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Medicare Market Marker The RemitDATA Denial Tracker SOURCE: REMITDATA: 901-767-9830 The RemitDATA Denial Tracker is an index of the percentage of Medicare and commercial claims rejected on a monthly basis. The most recent month's data represents an analysis of ap- proximately 1,422,701 Medicare claims and 3,997,417 commercial claims adjudicated between Apirl 1, 2017, and April 30, 2017. The index is a categorized and weighted analysis of claims fi led by RemitDATA customers. HMENEWS.COM 7/16 8/16 10/16 1/17 4/16 4/17 3/17 11/16 9/16 12/16 2/17 5/16 6/16 Most viewed stories in April 1. Tougher times ahead: Impact of rate cuts piles up 2. Cures Act update: Could bill in Minnesota serve as template? 3. CMS eases requirements for changing providers 4. Drive has all eyes on web 5. M&A: Buyer appetite for HME improves 6. ResMed prepares to grow demand for travel CPAPs *The Medicare Market Marker provides a monthly look at the number of Medicare benefi ciaries for whom the four MACs have allowed a claims payment. SOURCE: PDAC (number of allowed benefi ciaries) E 1 3 9 0 : O X Y G E N C O N C E N T R A T O R E 0 2 6 0 : S E M I - E L E C T R I C H O S P I T A L B E D (number of allowed benefi ciaries) E 0 6 0 1 : C P A P (number of allowed benefi ciaries) K 0 0 0 1 : S T A N D A R D W H E E L C H A I R (number of allowed benefi ciaries) (number of allowed benefi ciaries) K 0 8 2 3 : P O W E R W H E E L C H A I R * * HME NEWS POLL HMEDATABANK.COM The HME DataBank has the latest Medicare reimbursement data for the top 1,000 HME providers nationally in 103 key product cat- egories, as well as for all of the products in the NCB program. You can determine your market share, look for new product opportu- nities and check out your competition using the latest available Medicare data. Go to hmedatabank.com to learn more. data! data! **We are now tracking K0823 claims with certain modifi ers (NU, UE or RR/KH) to better refl ect the actual number of new allowed benefi ciaries under the 13-month capped rental. 2/16 11/16 10/16 12/16 1/16 3/16 4/16 8/16 9/16 5/16 6/16 7/16 "This is a major cash flow problem. We buy and pay for equipment, dispense to qualified Medicare recipients only to have to wait 3 to 4 years to be reviewed and hopefully paid." —Mary Klavoon "I have no claims at the ALJ level. We are very strict on pre-delivery documentation screen- ing to avoid denials." —Chris Townsend, Taffi Medical 129,336 Region D 107,355 Region B 84,748 Region A 32,118 Region C 19,199 Region A 8,134 Region D Region B 16,415 Region B 51,565 Region D 65,926 Region C 102,979 Region A 45,902 316 Region B Region D 274 862 Region C Region A 137 45,223 Region C 17,891 Region B 16,416 Region D 18,596 Region A Month Percent denied Source: The Braff Group, 412-833-5733. The Braff Group M&A Insider Rehab (19.2, 19.9) DME (15.3, 16) Respiratory (11.8, 11.5) 2/16 11/16 10/16 12/16 1/16 3/16 4/16 8/16 9/16 5/16 6/16 7/16 2/16 11/16 10/16 12/16 1/16 3/16 4/16 8/16 9/16 5/16 6/16 7/16 2/16 11/16 10/16 12/16 1/16 3/16 4/16 8/16 9/16 5/16 6/16 7/16 2/16 11/16 10/16 12/16 1/16 3/16 4/16 8/16 9/16 5/16 6/16 7/16 This month, we examine the mix of healthcare service transactions by sector. Leading the pack this year was behavioral health, which continues to draw substantial interest from private equity and strategic buyers alike, particularly in addictions and substance abuse treatment and autism services. Perhaps most notable, however, was the strong showing in home health. After falling off 30% in 2015, the sector roared back in 2016 with volume gains of more than 60%, largely on record breaking deal fl ow in private duty services. Do you have a claim/claims currently stuck at the ALJ level awaiting a hearing date(s)? NewsPoll based on 74 respondents. 233,609 Region C HME NEWS / JUNE 2017 / WWW.HMENEWS.COM Databank How old are the majority of these claims? 22

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