HME News

JUL 2018

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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Smart Talk 10 www.hmenews.com / july 2018 / hme news billing online learning The next generation of healthcare services. Professional Services An MHA Company Join us on our 50th anniversary for more information! July 10 - 11, 2018 Briscoe Western Art Museum San Antonio, TX 800-825-5633 first-in-class PAYER NETWORK. credentialing & EDUCATION. clinical programs. MARKETING. Don't fall for misconceptions By Ronda Buh R meste R Q. a s our company is executing more non-assigned claims, abn s are being utilized more frequently. a re abn s required for non- assigned claims? a . The quick answer is maybe. Let's start with some misconceptions in the industry about non-assigned claims. One of the misconceptions is that a supplier has no financial liability to get an ABN with non- assigned claims. Essentially, non- assigned means that the supplier is not accepting the fee schedule amount because the reimbursement is too low. The explanation on the ABN for a non-assigned claim cannot be "claim is being submitted as non- assigned." With a non-assigned claim, there still is financial liabil- ity, meaning the supplier needs to make sure the coverage criteria has been met according to the medical policy. If the coverage criteria is not met, this is when an ABN is imple- mented—whether it's an assigned or non-assigned claim. The purpose of an ABN is to inform a beneficiary in advance the reason Medicare may not pay for the service being provided. If the reason for denial on the ABN is "claim is non-assigned," this is not a valid reason and will be denied in an audit. ABNs are used for lack of medical necessity, same/simi- lar equipment, quantity exceeds allowed amount, and upgrades (not within the same code). Remember, the ABN speaks to the beneficiary, making sure they understand the information doc- umented on the form. The ABN allows the beneficiary to make an informed consumer decision about whether or not to receive the servic- es for which he or she may have to pay out of pocket or through other insurance. ABNs do get audited. If not used properly and completed as instruct- ed, an ABN will cause an unfavor- able decision in an audit. Be sure to review the ABN instruction manual with staff. hme Ronda Buhrmester is director of reim- bursement for The VGM Group. Reach her at ronda.buhrmester@vgm.com. Make your photos count By B R ie Cohen Vla C h Q. i 'm not a photographer. How do i take quality photos for patient education? a . Better photographs can make education easier for the patient to understand. It's all about the l I ght Pay attention to the natural light available to you. Use a window if you can–daylight is much nicer than harsh overhead yellow fluores- cent lights. Have the window light hit the subject from the front or the side. Avoid light behind the subject. If window light isn't enough light or you don't have access to natural out- door light, use daylight light bulbs. Turn off any built-in flash. Many beginner-level cameras come with a built-in flash, but I recommend using one of these other light sourc- es—natural outdoor light, a lamp with daylight bulbs, or photo lights. c ons I der I nvest I ng I n an entry-level dslr camera I recommend a Nikon or Canon. A beginner level DSLR camera is easy for an amateur to use, but produces a higher quality photo compared to a phone or point- and-shoot camera. g et r I d of the clutter You might be so focused on the subject, you forget to look at everything else. Step back. Remove unnecessary elements from the frame to make the picture less distracting. If there is a person in the picture, make sure they are not wearing anything busy. f rame the photo Make sure the most important ele- ment of the picture is large enough in the frame so the learner can eas- ily see what you are demonstrat- ing. Move closer—does the photo look better now? Notice the angle you are taking the picture. Try shooting straight on, at eye level, from above—what do you want the learner to see? hme Brie Cohen Vlach is education supervi- sor at Pediatric Home Service. Reach her at bgcohenvlach@pediatrichome- service.com.

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