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November 17, 2025
Denied durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claims can disrupt cash flow and patient care, but they don’t have to be the end of the road. Understanding the appeals process and preparing a strong response can...
In today's healthcare environment, understanding the nuances of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) audits is crucial for ensuring compliance and maintaining the financial health of your practice. A small oversight... On April 28, 2025, CMS awarded Cotiviti GOV Services LLC, the new RAC Recovery Audit Contractor (RAC) Region 3, 4, and 5 contracts. RAC Region 5 includes jurisdictions: JA, JB, JC, JD, as well as the HH/H MACs: J6, J15, JK, and JM.
Performant,... Noridian Healthcare Solutions, LLC (Noridian), as the Supplemental Medical Review Contractor (SMRC) for the Centers for Medicare and Medicaid (CMS), announced that they are conducting post-payment review of Medicare DME surgical dressing claims billed... December 16, 2024 The HME industry is a vital part of the healthcare ecosystem, providing essential services and equipment to patients in need. However, navigating the complex landscape of audits and compliance can be challenging. While the goal is to grow your HME business,... October 16, 2024 The Office of Inspector General (OIG) added two new DMEPOS items to their Work Plan for October 2024. See below for details.
Medicare Payments to Suppliers for Oxygen and Oxygen Equipment
Medicare covers reasonable and necessary durable medical... September 20, 2024 This post was originally featured in HME News.
Q. Should I be performing regular audits of my provider enrollment record?
A. Short answer, yes! Providers should review, or audit, their Provider Enrollment Record at least annually. In...