Tuesday, October 3, 2023
OANDP-L
  • Login
No Result
View All Result
The O&P EDGE
  • PECOS
  • Magazine
    • Subscription
    • Current Issue
    • Issue Archive
    • News Archive
    • Product & Service Directory
    • Advertising Information
    • EDGE Flipbooks
  • O&P Jobs
    • Find a Job
    • Post a Job
  • EDGE Advantage
    • EA Homepage
    • EA Data
  • O&P Facilities
  • Resources
    • Product & Service Directory
    • Calendar
    • Contact
    • About Us
    • O&P Library
    • The Guide
    • Custom Publications
    • Advertising Information
    • EDGE Direct
    • Amplitude Media Group
  • PECOS
  • Magazine
    • Subscription
    • Current Issue
    • Issue Archive
    • News Archive
    • Product & Service Directory
    • Advertising Information
    • EDGE Flipbooks
  • O&P Jobs
    • Find a Job
    • Post a Job
  • EDGE Advantage
    • EA Homepage
    • EA Data
  • O&P Facilities
  • Resources
    • Product & Service Directory
    • Calendar
    • Contact
    • About Us
    • O&P Library
    • The Guide
    • Custom Publications
    • Advertising Information
    • EDGE Direct
    • Amplitude Media Group
No Result
View All Result
The O&P EDGE Magazine
No Result
View All Result
Home On Topic

A Medicare Tool Belt

by Erin Cammarata
January 3, 2022
in On Topic
0
SHARES
71
VIEWS
Share on FacebookShare on Twitter

I used to do a presentation that started with a slide that said, “If I had a crystal ball and could tell you the future of healthcare….” As I was writing this article, that slide kept popping into my mind. Man, if I had a crystal ball. This year has brought about a lot of changes that no one saw coming, and I wish I could predict what the next few years will bring, specifically from Medicare.

While I still do not have a crystal ball, I can share a few tools you should have in your Medicare tool belt that will help you be prepared for anything Medicare throws your way.

Prior Authorizations

Medicare has finally rolled out the prior authorizations for several prosthetic codes. Phase 1 began in September in four states and for six procedure codes. Phase 2 will begin in December and will expand to all states and territories.

For prior authorization questions, visit cgsmedicare.com/jb/pubs/news/2020/03/cope16321.html.

To determine whether a prosthetic code is subject to prior authorization, visit cgsmedicare.com/medicare_dynamic/jb/pa/pa.aspx or med.noridianmedicare.com/web/jadme/cert-reviews/mr/pre-claim/required-programs/prior-authorization-for-llp

Audits

Audits were briefly suspended during the pandemic, but on August 3 pre- and post-payment audits resumed. We have seen an influx of audits in the past few months, which were not limited to Medicare. Checklists will help you prepare for audits, but do not wait for an audit to cross your desk to check your claims before you even bill the DME MAC. When used as part of your claims preparation process, checklists can help you to ensure your claims will pass an audit.

For a documentation checklist tool, visit cgsmedicare.com/jc/mr/documentation_checklists.html or med.noridianmedicare.com/web/jddme/policies/clinicians-corner/checklists.

 

Self-service Tools

Whether you’re looking for answers to questions about enrollment, coding, or same and similar items, this tool will become a favorite. The links provide telephone numbers and quick clicks to many useful websites at Noridian. Everything from claim status, eligibility, and same or similar to specific questions about claims and enrollment can be found. Some of my company’s favorite tools include the medically unlikely edit tool, appeals calculators, and the self-service portals.

 

For these tools, visit med.noridianmedicare.com/documents/2230703/6993576/Self%20Service%20Tools%20and%20Resources or med.noridianmedicare.com/web/jadme/education/calculators-tools

 

Medicare Learning Network (MLN)

Another great tool we use in our practice is MLN Matters. MLN articles focus on Medicare policy, billing, and payment policy. They also have training tools you can use in your practice to teach the Learning Management System to staff members.

 

To read MLN articles, visit
cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNGenInfo

 

Consolidated Billing

This is a great tool that will help determine if a code is payable for your patient during an inpatient stay. If your patient is in a skilled nursing facility or hospice, or during a home health episode, simply enter the HCPCS code to check at: cgsmedicare.com/medicare_dynamic/jc/consbill/consbill/index.aspx

Without a functioning crystal ball, we cannot know the future. As the Greek philosopher Heraclitus said, “The only constant in life is change.” Knowing that there will always be change, all we can do is continue to learn and adapt. Luckily for us in O&P, the DME MACs provide us with some great tools to help in our adaptations. Check out these tools, build up that tool belt, and charge on with confidence that you are ready to take on any challenges you and your practice may face.

 

Erin Cammarata is president and owner of CBS Medical Billing and Consulting. She can be contacted at [email protected].

Related posts:

  1. Final Rule Establishes Prior Authorization for Orthotics and Prosthetics
  2. Prior Authorization for Medicare O&P Services
  3. The RACs Are Coming: Preparing for Medicare Claims Denials of O&P Care
  4. New Medicare Rules Take Effect for O&P Care
Tags: On Topic
Previous Post

Anxiety Prevalent With Lower-limb Amputations

Next Post

Pedorthics and Online Sales, Are They Compatible?

Next Post

Pedorthics and Online Sales, Are They Compatible?

  • VIEW CURRENT ISSUE
  • SUBSCRIBE FOR FREE

RECENT NEWS

News

Call for Academy Member Awards Nominations

by The O&P EDGE
September 27, 2023

The American Academy of Orthotics and Prosthetics (the Academy) is accepting nominations through October 13 for the Academy Member Awards,...

Read more

Össur Program Meets Information Security Standard

Move United Seeks Host City For Adaptive Sports Competition

NAAOP Webcast: 2024 Officers and Policy Updates

Get unlimited access!

Join EDGE ADVANTAGE and unlock The O&P EDGE's vast library of archived content.
SUBSCRIBE TODAY

O&P JOBS

Eastern

Orthotic Assistant/Orthotic Fitter

Eastern

Full Time Certified Ped Orthotist

Eastern

CO/Certified Orthotist

 

© 2023 The O&P EDGE

  • About
  • Advertise
  • Contact
  • EDGE Advantage
  • OANDP-L
  • Subscribe

CONTACT US

866-613-0257

[email protected]

201 E. 4th St
Loveland, CO 80537

The most important industry news and events delivered directly to your inbox every week.

  • About
  • Advertise
  • Contact
  • EDGE Advantage
  • OANDP-L
  • Subscribe

© 2023 The O&P EDGE

No Result
View All Result
  • PECOS
  • MAGAZINE
    • SUBSCRIBE
    • CURRENT ISSUE
    • ISSUE ARCHIVE
    • NEWS ARCHIVE
    • PRODUCTS & SERVICES DIRECTORY
    • ADVERTISING INFORMATION
  • O&P JOBS
    • FIND A JOB
    • POST A JOB
  • EDGE ADVANTAGE
    • EA Homepage
    • EA Data
  • FACILITIES
  • RESOURCES
    • PRODUCTS & SERVICES DIRECTORY
    • CALENDAR
    • CONTACT
    • ABOUT US
    • O&P LIBRARY
    • THE GUIDE
    • CUSTOM PUBLICATIONS
    • ADVERTISING
    • EDGE DIRECT
    • AMPLITUDE
  • OANDP-L
  • LOGIN

© 2023 The O&P EDGE

Welcome Back!

Login to your account below

Forgotten Password?

Retrieve your password

Please enter your username or email address to reset your password.

Log In
The O&P EDGE Magazine
 
Required 'Candidate' login to applying this job. Click here to logout And try again
 

Login to your account

  • Forgot Password? | Sign Up

Reset Password

  • Already have an account? Login

Enter the username or e-mail you used in your profile. A password reset link will be sent to you by email.

Signup to your Account

  • By clicking checkbox, you agree to our Terms and Conditions and Privacy Policy

    Already have an account? Login

Close
Are you sure want to unlock this post?
Unlock left : 0
Are you sure want to cancel subscription?
 

Account Activation

Before you can login, you must activate your account with the code sent to your email address. If you did not receive this email, please check your junk/spam folder. Click here to resend the activation email. If you entered an incorrect email address, you will need to re-register with the correct email address.