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Audit Forecast: Recent Publications and Activities Hint at Audit Increases Across Multiple Payers

By Wayne van Halem, President, The van Halem Group There are a number of signs that are pointing to an increase in audit activity across multiple payers as the public health emergency (PHE) winds down. These increases can be expected not just...

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Coming Soon: PECOS 2.0

CMS recently announced several updates to the online Provider Enrollment Chain and Ownership System (PECOS). Beginning this summer, PECOS will unveil the latest version, touted by CMS to make the process of applying to “become a Medicare provider...

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Industry Veteran Kit Shellhouse Joins The van Halem Group

Atlanta, GA – Kit Shellhouse, formerly of ECS North and ACU-Serve, has joined The van Halem Group, a division of VGM Group, as the Director of Business Development. With her client-focused approach and more than 20 years of experience in the...

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Power Mobility Device (PMD) Accessory Voluntary Prior Authorization

CMS added the following PMD accessory HCPCS codes for voluntary authorization. The goal of this process is to increase operational simplicity by allowing suppliers to request prior authorization for a PMD accessory. The DME MACs will begin accepting...

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Updating your provider enrollment file? Use the current 855-S...or else!

CMS recently updated the 855-S DMEPOS supplier application, effective January 9, 2023. The new form can be found on the CMS Forms List and is currenlty being accepted for new enrollments and changes of information.  The National Provider Enrollment...

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Final Continuous Glucose Monitor (CGM) policy released

Medicare released the final draft of the new Glucose Monitor LCD and Policy Article with an effective date of 4/16/2023. The change was completed after a response to comments for the LCD. This new policy revamps the current CGM coverage criteria with...

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