In the world of durable medical equipment, you need to know how to navigate payer systems. You work in a highly regulated environment, as there’s a real potential for fraud, waste, and abuse within this field. Both private payers and DME MACs (Medicare Administrative Contractors) want to see real proof that a patient needs your help, and they are making some changes to their requirements. Are you ready to handle these changes?
Here at Medical Auditing Solutions, we help DME suppliers keep their finger on the pulse. Staying up to date is what we do, and we can help your team to understand what’s going on with the latest DME MAC updates. They decide when something is covered, how it’s covered, and they pay you, so staying compliant is key to avoid audits or investigations. Well, that’s what we do here at our office, so give us a call when you need to know more about billing, coding, and compliance.
If you’re still faxing your claims, it’s time to make the move to digital. Find out more about the latest DME MAC announcements with Medical Auditing Solutions.
Faxing Reopening Requests Are Out Starting August 1st
As of August 1st, CGS is moving people to alternative methods to improve speed and accuracy of processing. If you’re a CGS administrator in jurisdictions B or C, then faxing reopening requests is no longer an acceptable method. Handwritten forms are no longer accepted, either.
DME suppliers now must use one of three processes to submit. You can use the myCGS DME Web Portal, which is their preferred method. You can still submit reopening requests through telephone or by mail, too. If you’re having a tough time giving up the fax machine, talk to our team about ways to make the transition a little easier for your office.
Clarifying The KF Modifier For Class III Devices
For all jurisdictions, there is a new joint article about the use of the KF modifier. This modifier signals that a device is an FDA-designated Class III device, so MACs want to ensure that it is used appropriately. And there are some things to keep in mind here.
The primary point of this article is that a Class III designation belongs to the product. Your team needs to look at the manufacturer and model information to determine that it’s actually Class III before using the KF modifier. An incorrect use here could send up some audit red flags, so it’s important to do it right.
Learn More With Medical Auditing Solutions
When you’re working with people all day, it can be tough to stay up to date. That’s why we work with DME suppliers just like you to find efficient, compliant pathways. To find out more about our team, call Medical Auditing Solutions and My DME Billing at (972) 459-1508.