medicare audits
jkarnette
Description
Collection
Title:
medicare audits
Creator:
jkarnette
Date:
8/26/2005
Text:
To All Orthotic and Prosthetic Providers:
While at the AOPA Policy Forum in June I met with my senator and explained to him and his staff the problem of Medicare random audits and accompanying financial hardships on our industry. Today I followed up with him and reiterated our continued struggle. During this meeting he informed me that he and his staff meet monthly with the director of Medicare and requested that I assemble as many letters from other providers whose practices are being troubled by these audits. He would like at least 500 letters; more would be beneficial. The content can be simple and address the following points. Now is the time to act.
I have asked him to request that Medicare consider these points:
1. We need the checks of the audits, but once a company proves a reasonable compliance to the
medical necessity and guidelines required to provide services, it should be removed from auditing and the focus should be on educating the problem practices and bringing them into compliance.
2. We need a peer reviewer to audit, rather than as currently the reviewer having no understanding of orthotics and prosthetics
and the complex coding structure and diversity of services we provide.
3. As the DMERCs consolidate/modify O&P code structures, a credentialed O&P practitioner must be on the panel as
this applies to patient care and safety.
4. Since the business, not the individual practitioner, has the provider number, the only proper way to determine and
establish qualified providers is to require facility accreditation for any orthotic and prosthetic provider facility. I
prefer the ABC facility accreditation because of my experience as a surveyor.
If you are willing to assist please mail your letter to my office.
You do not have to be an owner to write a letter. ALL Practitioners should write a letter for the good of our field and their job security.
Thank you for your assistance,
Jeffrey Arnette, CPO
9511 E 46th street
Tulsa, OK 74145
918-663-7077
fax 918-663-7075
e-mail <Email Address Redacted>
While at the AOPA Policy Forum in June I met with my senator and explained to him and his staff the problem of Medicare random audits and accompanying financial hardships on our industry. Today I followed up with him and reiterated our continued struggle. During this meeting he informed me that he and his staff meet monthly with the director of Medicare and requested that I assemble as many letters from other providers whose practices are being troubled by these audits. He would like at least 500 letters; more would be beneficial. The content can be simple and address the following points. Now is the time to act.
I have asked him to request that Medicare consider these points:
1. We need the checks of the audits, but once a company proves a reasonable compliance to the
medical necessity and guidelines required to provide services, it should be removed from auditing and the focus should be on educating the problem practices and bringing them into compliance.
2. We need a peer reviewer to audit, rather than as currently the reviewer having no understanding of orthotics and prosthetics
and the complex coding structure and diversity of services we provide.
3. As the DMERCs consolidate/modify O&P code structures, a credentialed O&P practitioner must be on the panel as
this applies to patient care and safety.
4. Since the business, not the individual practitioner, has the provider number, the only proper way to determine and
establish qualified providers is to require facility accreditation for any orthotic and prosthetic provider facility. I
prefer the ABC facility accreditation because of my experience as a surveyor.
If you are willing to assist please mail your letter to my office.
You do not have to be an owner to write a letter. ALL Practitioners should write a letter for the good of our field and their job security.
Thank you for your assistance,
Jeffrey Arnette, CPO
9511 E 46th street
Tulsa, OK 74145
918-663-7077
fax 918-663-7075
e-mail <Email Address Redacted>
Citation
jkarnette, “medicare audits,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/225285.
