Our second Practice Engagement Program webinar this month featured Mike Demi, RN, CHC, CPC, CPMA, CSFAC  (wow that’s a lot of credentials!), Senior Consultant for Medical Compliance Associates and after nearly 90 minutes, the virtual hand raising, Q & A’s and chats were still rolling in! For those who missed it, no need to worry as the live recording and presentation PDF is now uploaded to the member-only library.

In case you are wondering what we covered, here is a preview:

• RAC Audits
  • Did you know that auditors are making commissions of up to 17.5% on takebacks?!
  • The most targeted audit areas and ways to improve documentation to reduce the chance of final denials and future takebacks including:
    • AFOs (custom and pre-fabricated)
    • E/Ms with procedures (using a 25 modifier)
    • Surgical Dressings
    • Facility vs. Non-facility work
    • And of course... Therapeutic shoes and inserts for diabetic patients
• Medicare DME and "Same or Similar"
  • Why they will deny (even if it doesn't make sense)
  • How to find out if a patient has received something "same or similar" in the past 5 years
  • When to have patients sign a statement that they do not recall receiving a "same or similar" device followed by an ABN if they have
  • When and how to appeal denials (verbiage tips, circumstances and examples of when you should "win")
  • Big reimbursement differences = more than minimal self-adjustment
• Diabetic Shoe documentation changes (verbiage, number of required "pieces of paper")
  • DWO is now SWO
  • The trouble with getting PCPs to "agree" to your findings
  • Timelines and dispensing
  • Charting verbiage to pass audits with flying colors
• Clarification of A5513 versus A5514 (ask your lab/shoe company which you should use and hope they know)...
• There was more but it's probably better if you just watch it!