Category: Dan Fedor

Every Penny Counts: Reopen CURES Act Adjusted Claims for an Additional 5%

The CURES Act adjustments are complete, and providers can submit a written reopening for affected accessories used on non-bid manual wheelchair bases (complex rehab) to receive an additional 5 percent. While 5 percent may not seem like much, it can add up, and in this reimbursement environment every penny counts. When the affected accessories are used …

Read More

Some Medicare Advantage Plans NOT Honoring the Beneficiaries First Month Purchase Option for Complex Rehab Power Chairs

Some Medicare Advantage Plans NOT Honoring the Beneficiaries First Month Purchase Option for Complex Rehab Power Chairs There has been an ongoing issue with Medicare Advantage plans that is significantly impacting complex rehab providers. As many beneficiaries migrate to Advantage plans, many providers are accepting agreements to service those patients. These plans state that they …

Read More

Great News: Mass Adjustment Payments are Starting!

By Ronda Buhrmester and Dan Fedor, VGM Reimbursement Specialists We are hearing from DME providers that they are starting to receive payments from both DME MACS Noridian and CGS. Noridian’s dashboard is reporting 6.1 percent of Jurisdiction D has been completed as of July 5. Jurisdiction A has completed 11.4 percent of their adjusted claims …

Read More

How to Navigate a Medicare System Limitation for Efficient Claim Submission

There is an ongoing issue with the Medicare processing system (VMS) denying accessories when more than nine line items are submitted. Due to a system limitation, when more than nine line items are submitted on one claim, the MAC processing system (VMS) splits the claim, and if the accessory codes are processed before the base item …

Read More