Martin Jacob, Author at Wonder Worth Solutions

CMS Proposes Market Oriented Reforms for Competitive Bidding Program

August 29, 2018
Martin Jacob
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A new CMS proposed rule would revise the national competitive bidding program with a blend of smaller, short-term tweaks and larger, more structural changes; provides longer relief for rural and non-competitive bid area providers; and addresses oxygen reimbursement. The Centers for Medicare & Medicaid Services took steps toward changing Medicare’s…

27 Aug 18

DME Suppliers: Ensuring Access To Medicaid for Dual Eligible Beneficiaries

Dual Eligible Beneficiaries may face special obstacles when they try to access services, such as durable medical equipment, that is covered to varying degrees by both Medicare and Medicaid. The Integrated Care Resource Center recently released a briefing titled “Facilitating Access to Medicaid Durable Medical Equipment for Dually Eligible Beneficiaries in…

22 Aug 18

How Claims Audit Can Make You Sick

How To Make Your CLAIM AUDIT Look Like A Million Bucks? HME businesses face increasing numbers of pre- and post-payment audits, which can be very stressful and costly events. Without a sound strategy for maintaining accurate and retrievable documentation, an audit request can disrupt operations and put your organization at…

20 Aug 18

How to Overcome Common Documentation Errors Identified by CERT & RACS?

Common Documentation Errors Identified by CERT & RACS. The Centers for Medicare & Medicaid Services calculates the Medicare Fee-for-Service (FFS) improper payment rate through the CERT program. Each year, CERT evaluates a statistically valid stratified random sample of claims to determine if they were paid properly under Medicare coverage, coding, and…

15 Aug 18

Medicare Documentation Guidelines For Durable Medical Equipment

The Centre for Medicare and Medicaid Services offers extensive and detailed DME Medicare documentation guidelines in general, as well as other guidelines for documentation that can be found in Local Coverage Determinations and National Coverage Determinations. Durable Medical Equipment billing continues to scrutinized by Medicare and other Commercial Carriers, so…

August 13, 2018
Martin Jacob
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On June 11, 2018, the Centers for Disease Control and Prevention (CDC) released the FY 2019 ICD-10-CM code changes. There are 473 code changes, including 279 new codes, 143 revised codes, and 51 deactivated codes. These codes are to be used from October 1, 2018 through September 30, 2019. The total…

August 6, 2018
Martin Jacob
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What is Medical Credentialing? For many licensed medical professionals, Medical Credentialing is known as 1) “the process of becoming contracted with insurance companies”, or 2) “the process of getting on insurance panels”, or 3) “what you need to do to be able to accept insurance.” If the process of credentialing is…

July 30, 2018
Martin Jacob
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Insurance companies provide coverage for care, items, and services that they deem to be “medically necessary”. Medical necessity is one of the most common reasons that insurers deny behavioral health claims. It is possible to get this type of denial overturned, but to do so; there are a few essential steps to…

25 Jul 18

Strategies to Mitigate Cyber Security Risks Of Your Practice

Cyber security is vital for businesses in every sector today. However, it’s particularly important for those in the healthcare sector. There are several reasons why businesses in this arena can’t afford to put off cyber security measures and why tomorrow may be too late to do what you should have…

Martin Jacob

CMS Proposes Market Oriented Reforms for Competitive Bidding Program

DME Suppliers: Ensuring Access To Medicaid for Dual Eligible Beneficiaries

How Claims Audit Can Make You Sick

How to Overcome Common Documentation Errors Identified by CERT & RACS?

Medicare Documentation Guidelines For Durable Medical Equipment

FY 2019 ICD-10-CM Codes Released: What You Need to Know

Medical Credentialing Basics: A Step-by-step Overview To Avoid Distress

Simple Steps to Appeal a Medical Necessity Denial Claims

Strategies to Mitigate Cyber Security Risks Of Your Practice

Navigating the Complexities of the Physician Self-Referral Law: A Comprehensive Guide for Healthcare Providers

Mastering DME Billing and Coding: Your Comprehensive Guide to Training and Certification

Finding the Right DME Billing Company Near You: A Comprehensive Guide

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