Date of Death Audits for DME & Inpatient Facilities

Beware, this is just one region that has published the date of death audit for DME and inpatient facilities such as rehab, hospital, LTC, SNF facilities.  This audit is done periodically and most suppliers are hit with a few thousand to upwards of $20K in overpayment refund requests.  Be prepared with a reserve of cash based on the size of your business.  At a minimum, I would suggest a set back of $5K even if you are outside of Region A.  Region A tends to publish this type of information earlier than other areas. These audits typically take place about every three years which is why the dollar amounts are so high.

We all know that payment after date of death will never be paid; however accidents will happen.  Ensure your billing staff doesn’t just “resubmit” claims without working the denial, this can cause a fraud audit even if you are not getting paid!  Likewise, if payment does occur it is usually less than 90 days from date of death when family fail to contact suppliers because they think the equipment belongs to the patient.  It could be a pick up ticket was not entered or a facility span date was not stopped at date of death instead of the full episode.  Note these are being audited by the RAC!

Republished:
NHIC, Corp.
DME MAC A ListServe
For Immediate Release
August 12, 2010

CMS Approved Audit Issues Posted for Region A Recovery Audit Contractor

DCS, the Medicare Recovery Audit Contractor (RAC) for Region A, recently posted new CMS approved audit issues for RAC review.

The new CMS approved audit issues are listed below and apply to the states of Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont.

* Date of Death – DME
* Date of Death – Inpatient

See the CMS approved audit issues at DCS’ RAC website: http://www.DCSRAC.com for more information.

Region A includes the states of Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont.

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Patient Visits: Changes, Increase Revenue, & Ordered Services

“15 MINUTE THOUGHT”

New Patient Visit Requirements: Increase Your Revenue

MAS is pioneering an informational program that you can listen to over a cup of coffee while you organize your day or on your drive to work. The name of the program is “15 Minute Thought”.  These calls will be free and informative.  Our focus is to give you a new thought once per month to help improve your business during these tough regulatory times.  The call participation should be maintained although CME/CEUs are not attached, it documentation of education efforts.

We will discuss health care reform changes that impact the requirements for patient visits, date last seen, and chart documentation.  We will discuss how to make lemonade out these lemons!  We need to cease the opportunity to increase revenues out of these changes.  Spend 15 minutes and learn about changes that can stop your payments as well as how to increase your revenue.

Program your Phone and Calendar:

The 2^nd* and 3^rd Wednesday Every Month

July 21, 2010  at 8:30am-8:45am CST

Speaker:          Angela Miller, CHC, Compliance & Billing Expert & Edward Vishnevetsky of Thompson Coe

MAS Conference Call Dial-in#:         218-862-1300

Conference Code:                               622911

MAS Office number:                          972-459-1508

Who should call in?

All health care provider, Health care business owner or manager, Physicians, Home Health, DME, HME, Attorneys, Compliance Officer, and Office Managers

Follow MAS Blog for Schedule & Updates.  You can “follow” MAS on all social media and new blog links are published.  We only publish useful information and breaking news.

Blog:  http://www.angelamillermas.wordpress.com or via website
Linkedin:  http://www.linkedin.com/in/medicalauditingsolutions
Facebook:  http://www.facebook.com/home.php#!/AngelaMiller.MAS

Edward L. Vishnevetsky has extensive experience in the area of health law and commercial litigation. He routinely argues before state and federal courts in areas of health law, employment law, and complex commercial litigation, and also represents hospitals, physicians, durable medical equipment (DME) providers and manufacturers before various state and federal regulatory agencies. Edward advises health care clients on operational matters, liability exposure, privacy issues, federal and state health care regulatory compliance, health care reimbursement disputes, as well as risk management issues. He has represented individuals, physician groups, hospitals, ambulatory surgery centers, sleep laboratories, dialysis clinics, independent diagnostic testing facilities, and DME suppliers.

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.

“15 Minute Thought” Schedule – Free Informational Programs

“15 MINUTE THOUGHT”

MAS is pioneering an informational program that you can listen to over a cup of coffee while you organize your day or on your drive to work. The name of the program is “15 Minute Thought”.  These calls will be free and informative.  Our focus is to give you a new thought once per month to help improve your business during these tough regulatory times.

Program your Phone and Calendar:

The 2^nd* and 3^rd Wednesday Every Month                 at 8:30am-8:45am CST

* Indicates specific audience

MAS Conference Call Dial-in#:         218-862-1300

Conference Code:                               622911

MAS Office number:                          972-459-1508

MAS Fax:                                               214-461-0295

Who should call in?

Any health care provider, Health care business owner or manager, Attorneys, Compliance Officer, and Office Managers

Schedule & Topics

July 14, 2010               Bankruptcy Attorneys & other Attorneys:  What you need to know about Medical Receivables*

July 21, 2010               Patient Visits: Changes, Increase Revenue, & Ordered Services

August 11, 2010         Physicians: NP & PA Visits: Can the non-physician provider be billed under the physician?*

August 18, 2010         Payer Audits Giving “RAC’d” a Whole New Meaning: Tips to Manage Audits

September 8, 2010      Conflict of Interest: Pay Attention or Write a Big Check

September 15, 2010    Compliance Officer:  Who? What? …Really?

October 13, 2010        Dental Providers:  Reform & Common Audit Errors*

October 20, 2010        Reserve Chute: Not just for jumping out of planes

There will be guest speakers.  We will release the brief description of the call within the next 24 hours.  There are plans to have Edward Vishnevetsky of Thompson Coe, Darrell Armer of Looper Reed & McGraw, David Reimer of Dental Medical Economics as well as others guest such as Advocate, MD present over the next few months as we roll this program out.  You will hear thoughts from some of the best in the health care industry.  The guest schedules are not finalized and they may participate in programs setup on this schedule.  We may increase the number of calls depending on the attendance.

Follow MAS Blog for Schedule & Updates.  You can “follow” MAS on all social media and new blog links are published.  We only publish useful information and breaking news.

Blog:  http://www.angelamillermas.wordpress.com or via website
Linkedin:  http://www.linkedin.com/in/medicalauditingsolutions
Facebook:  http://www.facebook.com/home.php#!/AngelaMiller.MAS

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.