In the world of medical compliance, especially when you are a DME supplier, standing out too much can get you noticed. Insurance payers and UPICs (Unified Program Integrity Contractors) pay attention when they see unusual behavior from offices, and they are now using advanced artificial intelligence technology to identify noncompliance. That’s leaving medical professionals across the country scrambling for answers on how to understand AI. Well, we’re here to tell you that solid documentation is protection.
With Medical Auditing Solutions, you have an opportunity to stay up to date. Our team sees what’s going on in the world of medical billing, coding, and compliance, and we help offices across the country to improve their efforts. Knowing how to navigate claims is a must in today’s DME insurance environment, so if you’re worried about triggering an audit, let’s talk. From making sure that your patients have corresponding Part B claims to understanding upcoding, our office is here for your office.
Rock solid documentation is an effective strategy for audit prevention. Develop a compliance plan with Medical Auditing Solutions.
DME Claims Are Seeing Increased Scrutiny
The way payers look at DME suppliers has changed significantly over the last few years. Auditing used to rely on random sampling and reviews primarily to identify fraud, waste, and abuse, but insurance payers, Medicare, and Medicaid all have new tools. Now, algorithms can comb through thousands of codes in a matter of seconds.
That means that there are some things to keep in mind if you’re a DME supplier. Your field requires some specific claim processes, and slipping up can cost you. You could be responsible for recoupments, see a loss of network status, or even be liable for criminal action. If you’ve got questions about coding, talk to a trusted team about ways to stay compliant consistently.
Solid Documentation Provides Claim Justification
So, it’s tougher than ever before for your average DME supplier to navigate claims. Missing Part B claim links can trip you up. Billing more than your colleagues in your area can also trigger an audit. How are you supposed to handle all of that?
Well, a big part of your strategy needs to be documentation. Contemporary healthcare compliance means that you need to know why an AI program might see your coding as unusual. By having documentation that provides explanation throughout, you’re better armed to state your case.
Compliance Questions? Call Medical Auditing Solutions
DME claims are tougher than they were just a few years ago. To find out more about documentation to defend against increased payer scrutiny, call Medical Auditing Solutions and My DME Billing at (972) 459-1508.