HME News

NOV 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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at Booth 1665 MedTrade Expo Atlanta, GA 8/24-25/2017 News 6 www.hmenews.com / november 2017 / hme news 810-653-5000 | uni v e r salss.com Serving the nation's largest providers WE'LL CARE FOR YOU, SO YOU CAN CARE FOR THEM. SO YOU CAN CARE FOR THEM. Your patients rely on you for quality care and peace of mind. Don't you deserve the same from your software provider? Trust your systems to Universal Software Solutions. We'll be here for you. Always. Let our HDMS software help you run and grow your HME practice. From estimates and customer intake to patient care and billing, our strong built-in workflow engine and powerful API will allow for tight integrations across platforms, giving you more time for what matters most: patient care. See what we can do for you: HME Providers Pharmacies Home Infusions Hospice Home Health Providers at Booth 1655 MedTrade Expo Atlanta, GA 10/24-25/2017 By Liz Beau L ieu, e ditor WASHINGTON – HME stakeholders and billing consultants are "cautiously optimistic" about a new program aimed at streamlining the number New audit program makes concessions of audits. CMS announced Aug. 14 that the Medicare Administrative Con- tractors will soon start focusing their reviews on providers that have the highest claim error rates or irregular billing practices, eliminat- ing the burden on providers who are already submitting claims that are compliant. "We're cautiously optimistic, but it's something we'll be moni- toring," said Kim Brummett, vice president of regulatory affairs for AAHomecare. On Oct. 1, as part of expanding its "Targeted Probe and Educate" program, the MACs turned off service-specific reviews and turned on these provider-specific reviews across all jurisdictions. A big reason for the optimism surrounding the program: After each of up to three rounds of probes of 20 to 40 claims per pro- vider, the MACs will offer indi- vidualized education to targeted providers based on the results of their reviews. "I'm excited about that," said Mary Stoner, president of Elec- tronic Billing Services in Sikeston, Mo. "That gives an opportunity for these providers to really get in there and learn what went wrong." The pause between probes for education also gives targeted pro- viders a breather from audits. "In the past, once providers got bad results, the audits were con- stant," said Kelly Wolfe, owner of r egency, Inc. in Largo, Fla. hme process. Provider Victoria Peterson said she echoes a number of providers when she says little has changed about Superior HealthPlan's approach to the contract. "In letters sent to patients, they are not encouraging patient choice, but encouraging patients to switch to the 'preferred provider,'" said Peterson, an administrator for r espiratory & Medical Homecare in El Paso, Texas. "It's their right to direct patients as they wish, but I don't believe they're strictly adhering to the state's intention in demanding that Superior Health- Plan conserve patient choice." hme Stakeholders are doubling down on their already strong relation- ships with Verma, whose name has been dropped as a potential replacement for Price. "We were able to get a meeting with her within two weeks of Price being confirmed," said Tom r yan, president and CEO of AAHomec- are. "She certainly knows who we are and is aware of the issues." Asked whether Price's resigna- tion means stakeholders and their champions in Congress need to step on the gas on legislation to reform the bid program, as well as eliminate a "double dip" cut to reimbursement for oxygen concen- trators, r yan said, "we're sorting that all out right now." hme Puts emphasis on education, rewards improved performance TO m pr I ce c o n t i n u e d f r o m pa g e 1 T ex AS c o n t i n u e d f r o m pa g e 4 b ATT le c o n t i n u e d f r o m pa g e 4 states where it operates but is not owned by Anthem. Following Medicare rates is noth- ing new, of course, but with those rates now at unsustainable levels, it's harder, if not impossible, for pro- viders to absorb. "It's going to put people out of business if they've held onto those contracts in the hopes that it will turn around," said Craig Douglas, vice president of payer and provid- er relations at VGM Group. "But if those payers represent 40% to 50% of a provider's book of business, they feel like they can't afford to walk away from it even if it's put- ting them underwater." hme medtrade booth 1655

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