Saturday, April 27, 2024

RAC prepayment audits

Kevin Matthews

I’m in Texas and am on the 7 state list for the new prepa
Hello All,

I’m in Texas and am on the 7 state list for the new prepayment audits.  We are now collecting all needed documentation before doing anything.  We explain Medicare’s new policy and the fact that they have the FBI in their back pocket…We need to do what we need to do.  Cursing they agree with our need for documentation before continuing.  It has not gone well.  Even with letters with Medicare standards easily spelled out, the notes are incomplete.  This has not been easy.  Mine is a primarily orthotic practice, which for now seems a blessing.  These prepayment audits are going to hurt a lot of people. 

I think the answer is pre-authorizations.  What if we think we have all the necessary information, but some little thing is lacking, wrong year on rx…They should assist us in the transition by providing pre-fabrication audits with authorizations.  They should absorb the cost of their changing the game and not educating physicians.The cost of componentry is significant, hence the reimbursement; but if denied we eat the cost all components!  They should allow prefab audits to teach us the standard and probably save money in avoiding fab.  I would also recommend Medicare send brochures explaining all the hoops the amputee needs to jump through to get a leg!  Kevin 

Kevin C. Matthews, CO/LO
Advanced Orthopedic Designs
12315 Judson Rd. #206
San Antonio, Texas 78233
210-657-8100
210-657-8105 fax
www.AdvancedOrthopedicDesigns.com
[email protected]

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