Medicare Prepayment Audits Region B
M. Britt Spears CPO, FAAOP
Description
Collection
Title:
Medicare Prepayment Audits Region B
Creator:
M. Britt Spears CPO, FAAOP
Date:
3/27/2013
Text:
Dear List,
We recently 12/19/12 delivered a bilateral BKA amputee with prosthesis. He was living in a different region-B than our office region C. We have been audited by region B on this claim. Among the items requested are obviously serial numbers of items delivered and physicians notes, but we included with the items requested additional items. Those included EKG, MRI records, extremely detailed MD notes and a QR video of this patient walking. These notes are above and beyond what is required by Medicare.
Guess what?? Now they are preforming a detailed audit on this patient. They are wanting K level assessment on a bilateral BKA amputee. It clearly states in Medicare's LCD that bilateral amputees do not specifically fall into any K levels. This QR video I sent shows him walking up and down inclines on uneven terrain even bouncing on the feet.
This is clearly a delay of payment tactic by Medicare. When can we as a whole send a message to Washington that this is unacceptable behavior? I'm totally fed up and feel sorry for our associates in region B!
M. Britt Spears, CPO, FAAOP
The content of this communication is for exclusive use of the
addressee and may contain confidential, privileged and non-disclosable
information. If the recipient of this communication is not the
addressee, such recipient is strictly prohibited from printing,
photocopying, saving on any media, distributing or otherwise using the
information contained herein. If you received this communication in
error, please contact the sender by e-mail, fax or telephone and destroy this document.
We recently 12/19/12 delivered a bilateral BKA amputee with prosthesis. He was living in a different region-B than our office region C. We have been audited by region B on this claim. Among the items requested are obviously serial numbers of items delivered and physicians notes, but we included with the items requested additional items. Those included EKG, MRI records, extremely detailed MD notes and a QR video of this patient walking. These notes are above and beyond what is required by Medicare.
Guess what?? Now they are preforming a detailed audit on this patient. They are wanting K level assessment on a bilateral BKA amputee. It clearly states in Medicare's LCD that bilateral amputees do not specifically fall into any K levels. This QR video I sent shows him walking up and down inclines on uneven terrain even bouncing on the feet.
This is clearly a delay of payment tactic by Medicare. When can we as a whole send a message to Washington that this is unacceptable behavior? I'm totally fed up and feel sorry for our associates in region B!
M. Britt Spears, CPO, FAAOP
The content of this communication is for exclusive use of the
addressee and may contain confidential, privileged and non-disclosable
information. If the recipient of this communication is not the
addressee, such recipient is strictly prohibited from printing,
photocopying, saving on any media, distributing or otherwise using the
information contained herein. If you received this communication in
error, please contact the sender by e-mail, fax or telephone and destroy this document.
Citation
M. Britt Spears CPO, FAAOP, “Medicare Prepayment Audits Region B,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/234850.
