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Your ABN Forms are Expiring!

When providing Durable Medical Equipment (DME) to Medicare Part B beneficiaries, there are certain situations where an Advanced Beneficiary Notice (ABN) may be required.  An ABN should be issued to the patient before they receive DME that is usually covered by insurance but is not in this particular case.  Issuing the ABN prior to delivery […]

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Choosing the Proper Dressing Size

When dispensing surgical dressings, the dressing size should be selected based on the size of the ulcer being treated.  From a clinical standpoint, the dressing should cover the entire ulcer.  From a compliance and payment standpoint, it is not appropriate to use a large dressing size when a smaller size was available that could have […]

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Setting S.M.A.R.T. Goals for Your Practice

What are you doing to achieve the goals set on January 1st? If you give a man a bow and arrow and tell him to shoot, the first thought in his mind will be, “Where?”.  Not knowing where to aim, the man will just shoot anywhere and at anything, not really caring, just because you […]

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The Best Method For Measuring a Wound

When dispensing surgical dressings, it is important that the dressing size is selected appropriately based on the size of the ulcer being treated.  The dressing should be large enough to cover the entire ulcer.  However, you cannot expect reimbursement for a dressing when a smaller size is available that could have covered the same ulcer.

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Updates to Surgical Dressing Documentation Requirements

AMERX Health Care provides you with extensive resources that include everything you need for perfect documentation to ensure compliance when dispensing surgical dressings.  The majority of this guidance comes from the DMEMAC Surgical Dressings LCD and the DMEMAC Surgical Dressing Policy Article.  On December 3, 2019, the DMEMACs released some additional guidance in the form […]

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How Much Are You Getting Paid For That? Part II

In last month’s post, we provided the information needed to access the current durable medical equipment (DME) and / or prosthetics (DMEPOS) fee schedule.  When opening the file for the current fee schedule, the HCPCS codes are listed from top to bottom in column A.  The reimbursement dollar value is listed for each state from […]

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6 Ways to Practice Smarter

In my previous blog, I discussed knowing your numbers to maintain a robust bottom line. Here are other practice management tips that can dramatically increase your bottom line. You must see patients. I am all for vacations and time off to recharge, but I find that some doctors take too many days off or reduce […]

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How Much Are You Getting Paid For That? Part 1

This should not be a guessing game, nor should it be a mystery.  Knowing what your reimbursement should be for a service is an important tool in planning treatments and in checking your Explanation of Benefits (EOBs).  This is the case with evaluation and management services, procedures, and durable medical equipment, including both surgical dressings […]

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Time to Start Using Medicare Beneficiary Identifiers

The Centers for Medicare and Medicaid Services (CMS) have removed social security-based claim numbers from Medicare cards and are instead using Medicare Beneficiary Identifiers (MBIs) for Medicare transactions.  All Medicare beneficiaries have received their MBIs, and it is important to collect that information. Physicians must start using the MBI instead of the social security number […]