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DME MAC Jurisdiction B News from CGS

Tuesday, April 10, 2018 @ 01:04 PM  posted by jbuytaert

Physicians! Your Medical Records Play a Vital Role in Ordering and Providing DMEPOS to Your Patients!

For any Durable Medical Equipment, Prosthetic, Orthotic and Supply (DMEPOS) item to be covered by Medicare, the patient’s medical record must contain sufficient information about the patient’s medical condition to substantiate the necessity for the type of equipment or supply, quantity and/or frequency of use or replacement, if applicable.

Medical documentation to support medical necessity should include pertinent and relevant information such as:
• Patient’s diagnosis
• Duration of the patient’s condition
• Clinical course (worsening or improvement)
• Prognosis, nature and extent of any functional limitation(s)
• Other therapeutic interventions and results, past experience with related items, etc.

For selected claims, various auditing entities may request this information from the DME supplier. These DME suppliers are your partners in caring for your patients. When questions arise about Medicare’s coverage criteria for an item, reach out to them for verification. They will not receive payment from Medicare for the items that are ordered if you do not provide information from your medical records when it is requested. In addition, when thorough medical records cannot be obtained by the DME supplier an Advance Beneficiary Notice of Non-coverage (ABN) may be the only resolution which will result in your patients having to pay for the items out of pocket.

Thursday, April 5, 2018 @ 08:04 AM  posted by jbuytaert

New Product: The FootFlexor by Core Products

Tuesday, April 3, 2018 @ 08:04 AM  posted by jbuytaert

Enriching Lives: Mike Burggraff

Friday, March 30, 2018 @ 08:03 AM  posted by jbuytaert

Last week I followed up with a customer’s father to see how his son’s wheelchair was doing. The process was a bit long getting the correct parts we needed to make the chair fully operational. Today I received a message from the customer’s father stating how much he appreciated Mike Burggraff working hard and coming through for them by getting the new controller the day before they left for a trip to Colorado. The father said that with the new controller his son has independence for the trip and that it made a big difference in his life.

Mike enriched the customer and his family’s life by coming through to meet a deadline that was important to the family. And selfishly for me, he enriched my life because I was able to listen to how Mike greatly impacted this customer’s life, and hear the excitement in the father’s voice. I’m very proud of Mike’s dedication and care for our customers.