Bad Debt Uncommon in Today’s Business Environment
According to a recent HME NewsPoll, in the current HME business environment, 80% of providers don’t want to negotiate deals. Instead, they prioritize reducing bad debt like uncollected patient co-pays. Bad debt load is common in today’s business and reimbursement environment. As seen in the poll, 46% of the respondents say their bad debt is more than 6%. Twenty-five percent say their bad debt is between 4% and 6%, while 29% say their bad debt is less than 3%.
Providers say that the reason for bad debt is attributed from economic weakness to patients and payers not paying. With this, providers are beginning to take harder approach with patients, making them understand in advance that they’re responsible for co-pays. However, providers believe that it is difficult to change the mindset of patients who can’t or won’t pay up.
Providers Seek Guidelines for the Re-Supply Change
According to stakeholders, CMS needs to clarify their new policy for re-supply orders because HME providers are having a hard time complying with documentation requirements. At the moment, providers need guidance on how to differentiate patients who need supplies from those who don’t, and how to prove it.
With the notice published on June 8 by CMS, which stated that providers can only replace items that need periodic replacement when they are no longer functional, all providers can do now is ask patients questions about the physical condition of their devices and document their answers. But, with the absence of clear guidelines, providers risk getting in trouble with auditors, stakeholders say.
CMS Warns of Approaching Deadline for Upgrading to Version 5010
In a recently issued reminder, the Centers for Medicare & Medicaid Services (CMS) emphasized that the enforcement discretionary period for upgrading to Version 5010 will end on Sunday, July 1, 2012. All entities covered by Health Insurance Portability and Accountability Act (HIPAA), who are doing business with CMS, were originally required to upgrade to Version 5010 by Jan. 1, 2012. However, CMS gave additional time so that providers will be able to fully comply with transaction standards for ASC X12 Version 5010 and NCPDP Versions D.0 and 3.0.
As published on CMS’ website, Version 5010 refers to the revised set of HIPAA electronic transaction standards adopted as replacement to the current Version 4010/4010A standards. Every standard, from claims to eligibility to referral authorizations, has been updated.
GAO asked to Examine Audit Activities
The Government Accountability Office (GAO) was asked by a group of high-ranking lawmakers to examine the efficiency of audit contractors. Gene Dodaro, comptroller general of the United States, received a letter from the leadership of the Senate Finance, House Energy and Commerce, and House Ways and Means Subcommittee on Oversight asking the GAO to conduct a study “that focuses on coordination among contractor efforts and CMS efforts to oversee these contractors to ensure that they are working efficiently.”
Several questions were given by lawmakers for GAO to evaluate. These include:
• What process does CMS use to determine whether the contractors’ audit criteria and methodologies are valid, clear and consistent?
• What are the reasons for requesting that similar information be submitted to multiple contractors?
• Does CMS have a strategic plan to coordinate and oversee all of its audit activities and, if so, how is that plan implemented and overseen?
A document containing a summary of comments collected by the Senate Finance Committee from the HME industry about the audit process with ideas to improve the process is expected to be released sometime this fall.
Supreme Court Upholds Healthcare Law
The healthcare reform had been challenged based on the “individual mandate,” which required almost all Americans to have health insurance by 2014 or pay a tax. Many people criticized the Congress for forcing citizens to buy health insurance. However, John G. Roberts Jr., Chief Justice of the Supreme Court, said that was not the issue at hand in the court’s decision.
With the decision, several elements directly impact HME providers. Among others, these include:
• Application of competitive bid pricing be applied nationwide by 2016, and as early as 2015.
• Elimination of the 2 percent fee schedule increase for bid items in 2014.
• A tax on medical devices.
- HME Business News Weekly Wrap-up Comparative Billing Report for Evaluation and Management Services to...
- HME Business News Weekly Wrap-up FMCSA Withdraws Sleep Apnea Guidance The Federal Motor Carrier...
- HME Business News Weekly Wrap-up NewsPoll Respondents Say One-Stop-Shop Could Drive Success According to the...
- HME Business News Weekly Wrap-up Providers Face Issues about Prior Treatments for Oxygen According...
- HME Business News Weekly Wrap-up Memo on HIPAA Rights to Access Health Records Released...