Audits and Appeals
Michael Johnson
Description
Collection
Title:
Audits and Appeals
Creator:
Michael Johnson
Date:
5/21/2013
Text:
Hello All,
I just learned something new and thought that this may be news to you too.
Just 2 weeks away from our first ALJ hearing (on an AK patient receiving a
foot back in 2009 with the audit and appeal process starting back in
February of 2012) and guess what? As of yesterday CMS is recouping not
only the reimbursement for the foot, but the entire prosthesis.
Apparently CMS is within their right to recover money in a timely manner
after the second appeal, while I have to wait longer and longer times to
even speak with the ALJ.
Chalk another one up for the government and their contractors. You know
that these ALJ's are swamped and the wait times are going to get longer.
Meanwhile we're getting hammered with pre and post payment audits, having
to hire extra staff just to do the paperwork (free employee for the
government), and without a hearing CMS can just take the money.
Is that news to you, or did I miss something?
--
Michael S. Johnson, CPO
OrthoPro of Twin Falls, Inc.
762 North College Road
Suite A
Twin Falls, ID 83301
208-733-0505
734-0766 fax
I just learned something new and thought that this may be news to you too.
Just 2 weeks away from our first ALJ hearing (on an AK patient receiving a
foot back in 2009 with the audit and appeal process starting back in
February of 2012) and guess what? As of yesterday CMS is recouping not
only the reimbursement for the foot, but the entire prosthesis.
Apparently CMS is within their right to recover money in a timely manner
after the second appeal, while I have to wait longer and longer times to
even speak with the ALJ.
Chalk another one up for the government and their contractors. You know
that these ALJ's are swamped and the wait times are going to get longer.
Meanwhile we're getting hammered with pre and post payment audits, having
to hire extra staff just to do the paperwork (free employee for the
government), and without a hearing CMS can just take the money.
Is that news to you, or did I miss something?
--
Michael S. Johnson, CPO
OrthoPro of Twin Falls, Inc.
762 North College Road
Suite A
Twin Falls, ID 83301
208-733-0505
734-0766 fax
Citation
Michael Johnson, “Audits and Appeals,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/235091.
