Noel Neil
Chief Compliance OfficerACU-Serve LLCAU03: Payer, Provider, and Advisor Panel on Fraud, Waste, Abuse, and Payment Integrity
In today’s evolving healthcare landscape, collaboration is key to combating fraud, waste, and abuse in the DMEPOS sector. This dynamic panel brings to…In today’s evolving healthcare landscape, collaboration is key to combating fraud, waste, and abuse in the DMEPOS sector. This dynamic panel brings together payers, providers, and consultants to shift the narrative from “us vs. them” to a unified app…In today’s evolving healthcare landscape, collaboration is key to combating fraud, waste, and abuse in the DMEPOS sector. This dynamic panel brings together payers, providers, and consultants to shift the narrative from “us vs. them” to a unified approach to payment integrity. Attendees will gain a comprehensive understanding of claims processing workflows, audit strategies, common fraud, waste, and abuse patterns, and recent trends. Panelists will share real-world insights and actionable strategies to foster transparency, improve compliance, and build trust across the healthcare continuum. Attendees will: 1. Understand the end-to-end claims processing lifecycle and how it impacts payment integrity as a provider and payer. 2. Be able to describe common fraud, waste, and abuse schemes and learn about current trends in the DMEPOS space and how they are identified. 3. Learn collaborative strategies that providers and payers can use to prevent fraud, waste, and abuse before it occurs. 4. Understand the role of advisors and compliance officers in bridging gaps between stakeholders. 5. Leave with action steps to enhance fraud, waste, and abuse prevention/detection and payment integrity efforts.Show MoreClick the title to see all details
AU07: UPIC Audits – The Who, What, Where, When and Why
Combating, fraud, waste and abuse remains a priority for the government. The UPIC remains one of the primary program safeguard contractors. Resultantl…Combating, fraud, waste and abuse remains a priority for the government. The UPIC remains one of the primary program safeguard contractors. Resultantly, UPIC audits are here to stay. Whether you are veteran or new to the DMEPOS industry, supplier sho…Combating, fraud, waste and abuse remains a priority for the government. The UPIC remains one of the primary program safeguard contractors. Resultantly, UPIC audits are here to stay. Whether you are veteran or new to the DMEPOS industry, supplier should have a solid understand of the important role of the UPIC and the authority they have at their disposal. Join Noel Neil and Attorney Michael Silverman for a comprehensive review of the UPIC. Individually and collaboratively, Noel and Michael have assisted suppliers navigate countless UPIC audits. The session will review the UPIC contractors, the role they play and what suppliers should do before, during, and after a UPIC audit. Come learn from their combined decades of experience of handling Medicare audits.Show MoreClick the title to see all details
PD04: The Lymphedema Treatment Act in Action: What’s Changed, What’s Next
Since its implementation in 2024, the Lymphedema Treatment Act (LTA) has significantly reshaped coverage and access to compression therapy across the …Since its implementation in 2024, the Lymphedema Treatment Act (LTA) has significantly reshaped coverage and access to compression therapy across the U.S. This session will explore the real-world effects of the LTA across Medicare, Medicaid, Managed …Since its implementation in 2024, the Lymphedema Treatment Act (LTA) has significantly reshaped coverage and access to compression therapy across the U.S. This session will explore the real-world effects of the LTA across Medicare, Medicaid, Managed Care, and private insurance. We’ll examine how various stakeholders—including clinicians, DME suppliers, and patients—have been impacted, and what challenges and opportunities remain. Attendees will gain insight into policy trends, billing practices, and advocacy strategies shaping the future of lymphedema care.Show MoreClick the title to see all details
WK04: Advanced Billing Workshop
This session builds upon the foundational content presented last year, offering a more comprehensive examination of critical challenges within the int…This session builds upon the foundational content presented last year, offering a more comprehensive examination of critical challenges within the intake, billing, collections, compliance, and audit processes. Attendees will gain insights into common…This session builds upon the foundational content presented last year, offering a more comprehensive examination of critical challenges within the intake, billing, collections, compliance, and audit processes. Attendees will gain insights into common operational pain points and receive actionable guidance for effectively addressing these issues. The presentation will feature interactive discussions and real-world case studies to enhance engagement and practical understanding. Key Topics of Discussion 1. Intake Process The session will underscore the importance of thorough insurance verification, including an in-depth discussion on CMS’s consolidation of billing across Skilled Nursing Facilities (SNF), Hospice, and Home Health (HH).Strategies will be presented for obtaining essential documentation when initial records lack sufficient detail to support medical necessity.Guidance will be provided on assembling a complete, billing-ready file, including accurate identification of the appropriate payment category for each product and a clear understanding of the corresponding billing requirements. 2. Billing and Collections Emphasis will be placed on the creation of clean claims that align with payer-specific billing guidelines, including the correct use of modifiers, narratives, span dates, and other critical elements. The variability among payers will be addressed.The session will explore best practices for achieving and maintaining a healthy accounts receivable, including key performance metrics and strategies for monitoring and responding to denial trends. 3. Compliance and Audit A review of CMS Quality and Supplier Standards will be conducted, highlighting the most frequent violations and offering practical approaches to mitigate risk.Attendees will gain an understanding of the various auditing entities and learn effective strategies for successfully navigating audit processes. Subject matter experts will present essential performance metrics across each operational area, equipping suppliers with the tools to monitor organizational health and drive continuous improvement. Participants will leave the session informed, confident, and empowered to implement best practices within their respective organizations.Show MoreClick the title to see all details
