Tag Archives: orthotics and prosthetics

Michigan BCBS adds certification requirement to bill O&P

Blue Cross Blue Shield of Michigan recently announced their plan to reject DMEPOS claims submitted for orthotics and prosthetics if the submitting provider has not provided certifying documentation proving they are certified to provide orthotics and prosthetics. Providers will be required to … Continue reading

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CMS Begins Rollout of Fingerprint Background Checks for DMEPOS Suppliers

According to recently released documents, early in 2014, CMS plans to award a contract to perform fingerprint analysis and background checks for certain Medicare providers and suppliers. It has been nearly three years since CMS released their final rule on developing … Continue reading

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Bowling for Denials

I wanted to pass along a very interesting post from Ossur’s R&R blog by David McGill on Medicare contract auditors trolling for information in an attempt to rewrite requirements for lower limb prostheses to their liking. If you are not … Continue reading

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ACA Health Exchange Enrollment Down, Medicaid Enrollment Up

Under fire since October 1st, the Obama Administration has finally announced the figures from the first month of the enrollment period for Americans to obtain health insurance in advance of the individual mandate becoming active in 2014. Under the mandate, … Continue reading

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Deal Reached to Fund Government, Raise Debt Ceiling

Leaders in the United States Senate yesterday unveiled a bipartisan plan to end the two-week long shutdown of th Federal government and raise the nations’ borrowing authority to avoid a default. The Continuing Appropriations Act extends current sequester level funding for the … Continue reading

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Quarterly Results of Prepayment Review of Spinal Orthoses

DMEMAC Jurisdiction D Medical Review Department released updated results on a widespread prepayment review program for spinal orthoses HCPCS codes, L0631 and L0637. The claims probed were from July 2013 – September 2013 and included a total of 2,112 claim … Continue reading

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Medicaid Expansion or Not, Expect Changes in Your State

While politicians in Washington DC struggle to relitigate the Affordable Care Act through a government shutdown, many key provisions and initiatives associated with the expansion of health insurance included in the ACA are continuing to march toward implementation. A key … Continue reading

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