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Audit Survey Demonstrates Impact on Home Medical Equipment Suppliers

Written by: Rebecca Bowden on Monday, July 31, 2017 Posted in: HME/DME

Home care organization shares latest data on HME audits but needs your help to more fully understand the issues.

It’s probably no surprise to any HME supplier that the number of audits continues to increase every year. In fact, according to data collected by the American Association for Homecare’s Audit Key, the average number of audits denied nationwide increased 9% since October 2015, when the organization began collecting audit data.

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This detail was recently released in AAHomecare’s Q1 2017 Audit Key report. The Audit Key is a free web-based survey to gather data to help quantify the impact of audits and appeals with the hope that the data can be used to encourage change.
Here are some of the most intriguing data revealed in the Q1 2017 report.

  • Most prepayment audits eventually get paid.
    71% of completed MAC prepayment audits were paid upon review
  • Two categories are least likely to be paid after prepayment review.
    74% of ostomy/urological, wound care, and diabetic supplies, as well as orthotics/prosthetics, are ultimately denied
  • Hospital beds, support surfaces, and manual wheelchairs are most scrutinized for new patients.
    37% were subject to MAC prepayment audit compared to just 11% for respiratory products and even less than that (single digits) for other major categories

While these findings are interesting, the AAHomecare team points out that the results are based on limited numbers of participating HME suppliers and may not accurately represent the entire industry. In order to develop a clearer picture of how audits are impacting HME/DME providers, AAHomecare needs more providers to participate.

Please consider sharing your audit experiences and outcomes with DME MAC, RAC, and SMRC reviews. Simply go to www.hmeauditkey.org and register to participate. Because the collected data is cumulative, you will not have to submit information related to individual claims.

As AAHomecare collects more data, it hopes to utilize the information to encourage improvements in the Medicare audit program. Participating HME suppliers also get access to their own quarterly survey results as well as aggregate survey results and key findings.

In the meantime, CareTend can help manage issues with audits by helping ensure compliant documentation processes. Learn more to help your HME/DME business send clean claims the first time.