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Correct Billing: PAP Devices

By Donna Youngblood, RN, Clinical Consultant A joint DME MAC article was released on 05/16/19 with long awaited guidance on billing procedures after a failed 12-week PAP trial. This guidance instructs suppliers on the correct use of the KX modifier...

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VGM opens Heartland conference to non-members

The van Halem Group is excited to announce, on behalf of its parent company, The VGM Group, that for the first time in VGM Heartland Conference’s 19 year history, the conference has opened registration to all HME providers. The move was driven...

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RAC Audit Alert: Upper Limb Orthoses

Performant Recovery posted one new automated issue to their approved issues list. Upper Limb Orthoses within the Reasonable Useful Lifetime (RUL) On May 17, 2019, Performant Recovery, the National DMEPOS RAC, added upper limb orthoses to their...

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No HIPAA compliance program? Be prepared to pay

By Kelli Ogunlesi, HIPAAwise Success Manager On May 6, 2019, the Office of Civil Rights published a press release regarding a settlement reached with a Tennessee diagnostic medical imaging services company for $3,000,000. This settlement was reached,...

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Proactive Compliance: Why it matters

By Wayne van Halem, President, The van Halem Group Why have a proactive compliance program? I mean it’s strongly suggested, but to date, there has been no real enforcement or penalties assessed to companies without one unless there have been significant...

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RAC Audit Alert: Therapeutic Shoes and Inserts for Persons with Diabetes and Knee Orthoses

Performant Recovery posted one new complex issue and one new automated issue to their approved issues log this month. Therapeutic Shoes and Inserts for Persons with Diabetes On April 26, 2019, Performant Recovery, the National DMEPOS RAC, added...

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CMS adds Upper Limb Orthosis to Proposed RAC topics list

CMS has added Upper Limb Orthoses within the Reasonable Useful Lifetime (RUL) to the proposed RAC issues list for DMEPOS items. This review will be automated. If approved by CMS, the RAC (Performant Recovery) will review claims for upper limb orthoses...

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Amendments and Corrections to Medical Records - A better understanding of Medicare’s standard record keeping principles

By Kim Turner RN, Clinical Consultant, The van Halem Group Just a quick review, the medical record is a subset of documents and data that you, the supplier, maintain relevant to a Medicare beneficiary.  Generally, the medical record documents/data...

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