Negotiating Managed Care Contracts – Part 2

December 22, 2018
AMARILLO, TX – Historically, DME suppliers have taken care of Medicare patients and have billed CMS directly. This is known as “Medicare fee-for-service” (or “Medicare FFS”). Also, historically, suppliers have taken care of state Medic

Negotiating Managed Care Contracts: Part 1 of 4

December 15, 2018
AMARILLO, TX – Historically, DME suppliers have taken care of Medicare patients and have billed CMS directly. This is known as “Medicare fee-for-service” (or “Medicare FFS”). Also, historically, suppliers have taken care of state Medic

Resources for Suppliers Considering Billing Non-Assigned — Dec. 31 Deadline to Change 2019 Status

December 9, 2018
While CMS has provided significant Medicare reimbursement relief for rural suppliers (as well as for those in non-contiguous areas such as Alaska, Hawaii, and Puerto Rico) via the recent ESRD/DMEPOS Final Rule, rates are set to remain largely unchang

ALJ Backlog and AHA Case: Recent Court Ruling

November 24, 2018
AMARILLO, TX – The current administrative appeals process is beyond unfair to DME suppliers. A supplier will get hit with a post-payment audit involving multiple patients. The auditing contractor will look for reasons to deny the claims and see

Competitive Bidding on Hiatus: Operating in the “Gap Period”

October 20, 2018
AMARILLO, TX – From Day 1 of competitive bidding, the DME industry sounded the alarm that the program would be unworkable. Industry stakeholders pointed out: “Low ball bidders” would submit bids in multiple CBAs…with no ability to tak

Noridian, CGS and the “60 Day Rule”

October 13, 2018
This is a reprint of the article that was published in last week’s Medtrade Monday. Medtrade Monday and the two authors decided to run this article a second time because of the importance of the topic. Note that Jeff and Wayne will present a webina